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Cancer. 2011 Jun 1;117(11):2364-70. doi: 10.1002/cncr.25720. Epub 2010 Dec 17.

Does delay of adjuvant chemotherapy impact survival in patients with resected stage II and III colon adenocarcinoma?

Author information

1
Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida. ubayraktar@med.miami.edu.

Abstract

BACKGROUND:

It is unclear whether delays in commencing adjuvant chemotherapy after surgical resection of colon adenocarcinoma adversely impact survival.

METHODS:

Patients with stage II-III colon adenocarcinoma who received adjuvant chemotherapy at 2 centers were identified through the institutional tumor registry. Time to adjuvant chemotherapy, overall survival (OS), and relapse-free survival (RFS) were calculated from the day of surgery. Patients were dichotomized into early (time to adjuvant chemotherapy ≤ 60 days) and late treatment (time to adjuvant chemotherapy >60 days) groups. OS and RFS were compared using log-rank test and multivariate analysis by the Cox proportional hazards model.

RESULTS:

Of 186 patients included in the study, 49 (26%) had received adjuvant chemotherapy >60 days after surgical resection. Thirty percent of the delays were system related (eg, late referrals, insurance authorizations). Time to adjuvant chemotherapy >60 days was associated with significantly worse OS in both univariate analysis and a Cox proportional hazards model (hazard ratio, 2.17; 95% confidence interval, 1.08-4.36). Although difference in RFS between the 2 groups favored time to adjuvant chemotherapy <60, this did not reach statistical significance.

CONCLUSIONS:

Adjuvant chemotherapy delay >60 days after surgical resection of colon cancer is associated with worse OS.

KEYWORDS:

5-fluorouracil; adjuvant chemotherapy; cancer therapy delay; colon cancer; disparity; oxaliplatin

PMID:
24048783
DOI:
10.1002/cncr.25720
[Indexed for MEDLINE]
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