The aetiology of delay to commencement of adjuvant chemotherapy following colorectal resection.
OBJECTIVE
Timely administration of adjuvant chemotherapy following colorectal resection is associated with improved outcome. We aim to assess the factors which are associated with delay to adjuvant chemotherapy in patients who underwent colorectal resection as part of an enhanced recovery protocol.


METHODS
A univariate and multivariate analysis of patient data collected as part of a prospectively maintained database of colorectal cancer patients between 2007 and 2012.


RESULTS
166 patients underwent colorectal resection followed by adjuvant chemotherapy. Median postoperative hospital stay was 6 days, and time to commencement of adjuvant chemotherapy was 50 days. Longer inpatient stay correlated with increased time to adjuvant chemotherapy (P = 0.05). Factors found to be independently associated with duration of hospital stay and time to commencement of adjuvant chemotherapy included stoma formation (P = 0.032), anastaomotic leak (P = 0.027), and preoperative albumin (P = 0.027). The use of laparoscopic surgery was associated with shorter time to adjuvant chemotherapy but did not reach significance (P = 0.143).


CONCLUSIONS
A number of independent variables associated with delay to adjuvant therapy previously not described have been identified. Further work may be required to elucidate the effect that these variables have on long-term outcome.
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK.
G S
GS
Simpson
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK.
R
R
Smith
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK ; University of Liverpool, Liverpool, Merseyside L69 3BX, UK.
P
P
Sutton
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK.
A
A
Shekouh
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK.
C
C
McFaul
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK.
M
M
Johnson
Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK.
D
D
Vimalachandran
D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery*; D000368:Aged; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D003082:Colectomy / Q000379:methods / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D061665:Time-to-Treatment