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

Gantt, Gerald; Ashburn, Jean; Kiran, Ravi P.; Khorana, Alok A.; Kalady, Matthew F.

doi:10.1007/s00464-014-3697-1

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…There was no decrease in survival in the laparoscopic group. 2 We also found no significant differences between laparoscopic and robotic MIS approaches for time to chemotherapy and other outcomes. Our study showed time from surgery to chemotherapy more comparable to the NCD study, with about 30% of our MIS patients and about 50% of open colorectal resections starting chemotherapy >8 weeks after surgery.…”

Section: Discussionmentioning

confidence: 55%

A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery

Patel

Battaglia

Shanker

et al. 2021

The American Surgeon

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Background Oncologic outcomes for colon cancer are optimal when chemotherapy is started within 6 to 8 weeks after surgery. The study objective was to investigate the impact of operative modality and urgency on the time interval from surgery to adjuvant chemotherapy. Methods This is a retrospective institutional tumor registry cohort study of open and laparoscopic/robotic colorectal resections for stage II-IV cancer between April 2010 and January 2018. Primary outcome was time from surgery to chemotherapy. Predictor variables were adjusted for imbalances by propensity score weighting. Results A total of 220 patients met inclusion criteria: 171 elective (108 laparoscopic/robotic and 63 open) and 49 urgent colectomies. After propensity score weighting, there was no significant difference in time to chemotherapy between elective minimally invasive and open surgical approaches (48 days vs. 58 days, P = .187). Only 68.9% of minimally invasive and 50.8% of open colectomy patients started chemotherapy within 8 weeks of surgery. There was a significant difference ( P = .037) among surgical sites with rectal resections having the longest (55 days), and right colectomies having the shortest (46 days), time to chemotherapy. Patients who had urgent operations had significantly longer hospital length of stay ( P < .001) and higher post-discharge emergency department visit rates ( P < .001) than the elective operation group. However, there was no significant difference in time to chemotherapy. Discussion Neither operative modality nor operative urgency resulted in a significant difference in postoperative time to initiating chemotherapy. Future efforts should be focused on identifying postoperative recovery criteria and optimum multidisciplinary communication methods that allow recovered patients to start chemotherapy sooner.

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Section: Discussionmentioning

confidence: 55%

A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery

Patel

Battaglia

Shanker

et al. 2021

The American Surgeon

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“…Because of retrospective data collection, our study also presents a potential information bias. Moreover, we were not able to analyse some risk factors suggested in other studies such as tumour grade, 5,26,38 marital status, 5,26 socioeconomic status 26,31,39,40 and patient comorbidities 5,26,39,41–43 …”

Section: Discussionmentioning

confidence: 92%

“…Moreover, we were not able to analyse some risk factors suggested in other studies such as tumour grade, 5,26,38 marital status, 5,26 socioeconomic status 26,31,39,40 and patient comorbidities. 5,26,39,[41][42][43] Finally, we used an MFP approach which has several advantages over the current approach of categorising continuous variables, especially regarding relationship modelling, quality of fit and power. 44 Our study suggests that in addition to colectomy following an ED visit and placement of stoma, factors related to health care organisation (additional scheduled care after colectomy, extended time-to-PMM) and access to care (travel time to hospital) could be associated with a higher risk of late aCT administration after colectomy, which is…”

Section: Weaknesses and Strengths Of This Studymentioning

confidence: 99%

Are patients living far from hospital at higher risk of late adjuvant chemotherapy for colon cancer?

Vermeulin

Lahbib

Lucas

et al. 2022

Brit J Clinical Pharma

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Aims Late adjuvant chemotherapy (aCT) administration after colectomy (>56 d) is known to be associated with impaired prognosis. We aim to identify risk factors associated with late aCT, especially the travel time between patients' home and hospital. Methods We performed a retrospective monocentre cohort study. Patients included had a colectomy for a stage III or high risk stage II colon cancer between 2009 and 2015 performed at a French university hospital. Risk factors for late aCT were identified using a fractional polynomial logistic regression. Results Ninety‐four patients were included. The risk of late aCT was associated with travel time length, emergent colectomy, the need for scheduled care before aCT, and length of time between colectomy and postoperative multidisciplinary meeting advising aCT. Conclusion Our study suggests that, in patients with colon cancer, factors unrelated to disease severity and complexity could be associated with a higher risk of late aCT.

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“…Even though we did not find a significant correlation between complications and IDRF-Status (which may be explained through a low patient number), we described a significant correlation for surgical complications and OS. Patients who suffer from complications after oncological surgery experience often a delay in further treatment with chemotherapy and/or radiation, which may lead to further tumor progression and therefore, decreased OS [1,11,19,24]. Hypothetically speaking, this might be applicable for NB as well.…”

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confidence: 99%

Image-defined Risk Factors Correlate with Surgical Radicality and Local Recurrence in Patients with Neuroblastoma

et al. 2016

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

Abstract: The benefits of quicker recovery after laparoscopic surgery did not translate into earlier initiation of adjuvant chemotherapy in this retrospective study. However, a laparoscopic approach negated the inferior oncologic outcomes of patients who received delayed initiation of chemotherapy.

Cited by 7 publications

References 23 publications

A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery

A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery

Are patients living far from hospital at higher risk of late adjuvant chemotherapy for colon cancer?

Image-defined Risk Factors Correlate with Surgical Radicality and Local Recurrence in Patients with Neuroblastoma

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