Does delay of adjuvant chemotherapy impact survival in patients with resected stage II and III colon adenocarcinoma?
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.
Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida. ubayraktar@med.miami.edu.
Ulas Darda
UD
Bayraktar
Emerson
E
Chen
Soley
S
Bayraktar
Laurence R
LR
Sands
Floriano
F
Marchetti
Alberto Jose
AJ
Montero
Caio Max S
CM
Rocha-Lima
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012307:Risk Factors; D013997:Time Factors
D000970:Antineoplastic Agents
5-fluorouracil; adjuvant chemotherapy; cancer therapy delay; colon cancer; disparity; oxaliplatin