Impact of therapeutic delay in colorectal cancer on overall survival and cancer recurrence – is there a safe timeframe for prehabilitation?

Strous, Maud T. A.; Janssen‐Heijnen, M.L.G.; Vogelaar, F. Jeroen

doi:10.1016/j.ejso.2019.07.009

Cited by 40 publications

(60 citation statements)

References 27 publications

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“…However, literature remains contradictory. For example, a systematic review of 34 studies (2000–2020) on 17 therapy indications by Hanna et al found a consistent and significant increase in mortality for each 4 weeks delay of cancer surgery, with a hazard ratio of 1.06 (95% CI 1.01–1.12) for colectomy [ 34 ], and Lee showed that the risk of death was increased for patients with a waiting time of more than 30 days between diagnosis and treatment [ 35 ], whereas Strous et al and Trepanier et al showed that treatment exceeding a month did not decrease overall and recurrence-free survival [ 36 , 37 ]. Amri et al did not find worse cancer outcomes for treatment delay in colon cancer and even found an inverse relation between treatment delay and mortality and recurrence rates [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Interhospital referral of colorectal cancer patients: a Dutch population-based study

Warps

Babberich

Dekker

et al. 2021

Int J Colorectal Dis

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Purpose Interhospital referral is a consequence of centralization of complex oncological care but might negatively impact waiting time, a quality indicator in the Netherlands. This study aims to evaluate characteristics and waiting times of patients with primary colorectal cancer who are referred between hospitals. Methods Data were extracted from the Dutch ColoRectal Audit (2015-2019). Waiting time between first tumor-positive biopsy until first treatment was compared between subgroups stratified for referral status, disease stage, and type of hospital. Results In total, 46,561 patients were included. Patients treated for colon or rectal cancer in secondary care hospitals were referred in 12.2% and 14.7%, respectively. In tertiary care hospitals, corresponding referral rates were 43.8% and 66.4%. Referred patients in tertiary care hospitals were younger, but had a more advanced disease stage, and underwent more often multivisceral resection and simultaneous metastasectomy than non-referred patients in secondary care hospitals (p<0.001). Referred patients were more often treated within national quality standards for waiting time compared to non-referred patients (p<0.001). For referred patients, longer waiting times prior to MDT were observed compared to non-referred patients within each hospital type, although most time was spent post-MDT. Conclusion A large proportion of colorectal cancer patients that are treated in tertiary care hospitals are referred from another hospital but mostly treated within standards for waiting time. These patients are younger but often have a more advanced disease. This suggests that these patients are willing to travel more but also reflects successful centralization of complex oncological patients in the Netherlands.

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Section: Discussionmentioning

confidence: 99%

Interhospital referral of colorectal cancer patients: a Dutch population-based study

Warps

Babberich

Dekker

et al. 2021

Int J Colorectal Dis

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“…Associations between TI and OS or CSS in colon cancer were reported in ten studies [21][22][23][24][25][26][27][28][29][30], of which four studies [21,24,25,30] found no association between TI and OS (Table 3). In contrast, six studies found a significant negative or a U-shaped association between TI and OS [22,23,26,27] or CSS [28,29].…”

Section: Time To Treatment Initiation and Survival In Colon Cancermentioning

confidence: 99%

The Association Between Treatment Interval and Survival in Patients With Colon or Rectal Cancer: A Systematic Review

et al. 2021

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Background Surgery for colon or rectal cancer is associated with a high incidence of complications, especially in patients with a low aerobic fitness. Those patients might benefit from a comprehensive preoperative workup including prehabilitation. However, time between diagnosis and treatment is often limited due to current treatment guidelines. To date, it is unclear whether the treatment interval can be extended without compromising survival. Methods A systematic review concerning the association between treatment intervals and survival in patients who underwent elective curative surgery for colon or rectal cancer was performed. A search up to December 2020 was conducted in PubMed, Cinahl and Embase. Original research articles were eligible. Quality assessment was performed using the Downs and Black checklist. Results Eleven observational studies were included (897 947 patients). In colon cancer, treatment intervals that were statistically significant associated with reduced overall survival or cancer-specific survival ranged between > 30 and > 84 days. In rectal cancer, only one out of four studies showed that treatment intervals > 49 days was associated with reduced cancer-specific survival. Conclusions This systematic review identified that studies investigating the association between treatment intervals and survival are heterogeneous with regard to treatment interval definitions, treatment interval time intervals and used outcome measures. These aspects need standardization before a reliable estimate of an optimal treatment interval can be made. In addition, further research should focus on establishing optimal treatment intervals in patients at high risk for postoperative complications, as particularly these patients might benefit from extended diagnosis to treatment intervals permitting comprehensive preoperative preparation.

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“…Similar results were also obtained when the same data were examined for day 49. [9] In another study, Wanis et al compared 908 stage I-III colon cancer patients with respect to disease-free survival and overall survival according to the time from diagnosis to surgery. [10] The comparison of those who had surgery earlier or later than 30 days revealed that there was no difference in overall survival or disease-free survival, and furthermore, there was no difference even when the threshold was taken as 60 and 90 days.…”

Section: The Guidelines and Recommendations Of International Associatmentioning

confidence: 99%

The COVID 19 Pandemic and Colorectal Cancer: 5W1H - What Should We Do to Whom, When, Why, Where and How?

Akyol¹,

Koç²,

Utkan³

et al. 2020

tjcd

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Kansere bağlı ölümlerin önemli bir nedeni olan ve halen önemli bir toplum sağlığı sorunu olan kolorektal kanserin tedavisi, Aralık 2019'da ortaya çıkan COVID-19 pandemisi nedeniyle tartışma konusu halini almıştır. Yapılacak düzenlemeler hastaların pandemiden daha az etkilenmesini, hastane kaynaklarının pandemi için daha etkili kullanılmasını sağlamalı, sağlık çalışanlarını riske sokmadan planlanmalıdır. Ancak onkolojik ve cerrahi sonuçların bu yapılacak tedavi değişikliklerinden etkilenmemesi ana amaç olmalıdır. Bu çalışmada, kişiselleştirlmiş tedavi ile güncel uluslararası kılavuzlar da tartışılarak, pandemi döneminde kolorektal kanserin cerrahi, kemoterapi, radyoterapi seçenekleri kullanılarak multimodal tedavisinin nasıl planlanacağı tartışılmıştır.

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Impact of therapeutic delay in colorectal cancer on overall survival and cancer recurrence – is there a safe timeframe for prehabilitation?

Cited by 40 publications

References 27 publications

Interhospital referral of colorectal cancer patients: a Dutch population-based study

Interhospital referral of colorectal cancer patients: a Dutch population-based study

The Association Between Treatment Interval and Survival in Patients With Colon or Rectal Cancer: A Systematic Review

The COVID 19 Pandemic and Colorectal Cancer: 5W1H - What Should We Do to Whom, When, Why, Where and How?

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