Adjuvant Chemotherapy for Stage III Colon Cancer: Does Timing Matter?

Abstract

Delaying adjuvant chemotherapy in stage III colon cancer beyond 8 to 10 weeks postsurgery appears to be associated with diminished benefit.

Association Between Time (Initiation and Length) and Oncological Outcomes for the Patients with Colon Cancer Treated with Adjuvant Chemotherapy

“…The results showed that patients who started adjuvant chemotherapy within 6 weeks tended to have a higher 5-year DFS rate than those who started it later. This result is similar to that of other studies [24][25][26], reporting that it is beneficial to start adjuvant chemotherapy within 6 weeks after surgery. However, as previous studies and our study show, initiating chemotherapy too early does not guarantee a satisfactory 5-year DFS rate.…”

“…[9]. Numerous studies have reported that patients who start adjuvant chemotherapy 6-8 weeks after surgery have better survival rates than those who do not [24][25][26]. We analyzed the 5-year DFS rates of patients who started chemotherapy within 4 weeks (group 1, 80.26 %), within 4-6 weeks (group 2, 83.03 %), and >6 weeks (group 3, 70.08 %) after resection, but found no differences (p=0.2096).…”

Laparoscopy mitigates adverse oncological effects of delayed adjuvant chemotherapy for colon cancer

“…In the literature, the proportion of patients who have delayed initiation of CT ranges from 20 to 72 % [5][6][7][8]16]. This is consistent with our data, as approximately one third of patients received adjuvant CT greater than 8 weeks after [10] found that the length of postoperative hospital stay, age, and race were associated with initiating CT more than three months following surgery.…”

“…Adjuvant CT has been shown to increase survival in these patients [3,4]. Previous studies have shown that delaying initiation of adjuvant CT greater than 8 weeks after surgical resection adversely affects overall patient survival [5][6][7][8]. A number of demographic, clinical, and systemic factors have been associated with delay in the initiation of CT, including age, race, and postoperative length of stay [9,10].…”

Factors Associated with Delayed Time to Adjuvant Chemotherapy in Stage iii Colon Cancer

“…This real-world pattern has previously been reported in the published literature; however, the rates in British Columbia are higher than those reported in other provinces in Canada 8,9 . Comparing retrospective studies is difficult, but the proportion of patients with delayed chemotherapy ranges from 26% in Alberta 11 to 32% in Winnipeg 12 and 35% in Saskatchewan 13 . Although the definition of delayed chemotherapy varies, most studies have accepted fewer than 56 days as the standard against which to judge delay.…”