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

  1. Ulas Darda Bayraktar MD1,†,*,
  2. Emerson Chen BA2,
  3. Soley Bayraktar MD1,
  4. Laurence R. Sands MD3,
  5. Floriano Marchetti MD3,
  6. Alberto Jose Montero MD1,
  7. Caio Max S. Rocha-Lima MD1

Article first published online: 17 DEC 2010

DOI: 10.1002/cncr.25720

Issue

Cancer

Cancer

Volume 117, Issue 11, pages 2364–2370, 1 June 2011

Additional Information

How to Cite

Bayraktar, U. D., Chen, E., Bayraktar, S., Sands, L. R., Marchetti, F., Montero, A. J. and Rocha-Lima, C. M. S. (2011), Does delay of adjuvant chemotherapy impact survival in patients with resected stage II and III colon adenocarcinoma?. Cancer, 117: 2364–2370. doi: 10.1002/cncr.25720

Author Information

  1. 1

    Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida

  2. 2

    University of Miami Miller School of Medicine, Miami, Florida

  3. 3

    Division of Surgical Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida

  1. †

    Fax: (305) 585-0037

*Sylvester Comprehensive Cancer Center, 1475 NW 12th Ave St 3300, Miami, FL 33136

Publication History

  1. Issue published online: 19 MAY 2011
  2. Article first published online: 17 DEC 2010
  3. Manuscript Accepted: 24 SEP 2010
  4. Manuscript Revised: 20 AUG 2010
  5. Manuscript Received: 10 JUN 2010

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Keywords:

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

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. Cancer 2011;. © 2010 American Cancer Society.

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