Time to adjuvant chemotherapy following colorectal cancer resection is associated with an improved survival

Colorectal Dis. 2014 May;16(5):368-72. doi: 10.1111/codi.12570.

Abstract

Aim: Multicentre randomized trials have demonstrated equivalent long-term outcomes for open and laparoscopic resection of colon cancer. Some studies have indicated a possible survival advantage in certain patients undergoing laparoscopic resection. Patients who receive adjuvant chemotherapy in < 8 weeks following surgery can have an improved survival.

Method: Data were collated for patients having an elective laparoscopic or open resection for non-metastatic colorectal cancer between October 2003 and December 2010 and subsequently having adjuvant chemotherapy. Survival analysis was conducted.

Results: In all, 209 patients received adjuvant chemotherapy following open (n = 76) or laparoscopic (n = 133) surgery. Median length of stay was 3 days with laparoscopic resection and 6 days with open resection (P < 0.0005). Median number of days to initiation of adjuvant chemotherapy was 52 with laparoscopic resection and 58 with open resection (P = 0.008). The 5-year overall survival was 89.6% in patients receiving chemotherapy in < 8 weeks after surgery, compared with 73.5% who started the treatment over 8 weeks (P = 0.016). The 5-year overall survival for those patients with a laparoscopic resection was 82.3% compared with 80.3% with an open resection (P = 0.049).

Conclusion: There is an overall survival advantage when patients receive adjuvant chemotherapy < 8 weeks after surgery. Laparoscopic resection allows earlier discharge and, subsequently, earlier initiation of adjuvant chemotherapy.

Keywords: Laparoscopy; chemotherapy; colorectal; survival.

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Period
  • Retrospective Studies
  • Survival Rate
  • Time Factors

Substances

  • Antineoplastic Agents