Improved survival with early adjuvant chemotherapy after colonic resection for stage III colonic cancer: A nationwide study.
OBJECTIVE
In stage III colonic cancer, time from surgery to start of adjuvant chemotherapy may influence survival. In this study, we evaluated the effect of timing of adjuvant therapy on survival.


METHODS
Database study from the Danish Colorectal Cancer Group's national database. Data on patients with stage III colonic cancer operated between January 1, 2005 and August 31, 2012 were retrieved. Perioperative variables, surgical modality, and time to adjuvant therapy (<4, 4-8, or >8 weeks) were evaluated and Cox regression was performed to identify factors influencing survival.


RESULTS
The final population included 1,827 patients scheduled for adjuvant chemotherapy. Adjuvant therapy started within 4 and 8 weeks improved survival when compared to start later than 8 weeks (HR [95%CI]: 1.7 [1.1-2.6]; P = 0.024 and 1.4 [1.07-1.8]; P = 0.013, respectively), whereas there was no significant difference in survival with start after 4 versus 8 weeks (1.2 [0.8-1.8]; P = 0.37).


CONCLUSIONS
Survival increased when adjuvant therapy was started within 8 weeks after surgery for stage III colonic cancer.
Department of Surgery, Centre for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Mads
M
Klein
Department of Surgery, Centre for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Najah
N
Azaquoun
Department of Oncology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Benny Vittrup
BV
Jensen
Department of Surgery, Centre for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Ismail
I
Gögenur
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000401:mortality*; D003082:Colectomy / Q000401:mortality*; D003110:Colonic Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
adjuvant therapy; colonic cancer; laparoscopy; stage III; timing