title: Time-to-administration in postoperative chemotherapy for colorectal cancer: does minimally-invasive surgery help?
abstract: The optimal delay in the start of chemotherapy following rectal cancer surgery has not yet been identified. However, postponed adjuvant therapy has been proven to be connected with a significant survival detriment. We aimed to investigate whether the time to initiation of adjuvant treatment can be influenced by the application of minimally invasive surgery rather than traditional open surgery. By comprehensively evaluating the available inherent literature, several factors appear to be associated with delayed postoperative chemotherapy. Some of them are strictly related to surgical short-term outcomes. Laparoscopy results in shortened length of hospital stay, reduced surgical morbidity and lower rate of wound infection compared to conventional surgery. Probably due to such advantages, the application of minimally-invasive surgery to treat rectal malignancies seems to impact favorably the possibility to start adjuvant chemotherapy within an adequate timeframe following surgical resection, with potential improvement in patient survival.
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy - stefano.amore.b@gmail.com.
authors.forename: Stefano
authors.initials: S
authors.lastname: Amore Bonapasta
authors.forename: Paolo
authors.initials: P
authors.lastname: Checcacci
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerra
authors.forename: Vita M
authors.initials: VM
authors.lastname: Mirasolo
authors.forename: Luca
authors.initials: L
authors.lastname: Moraldi
authors.forename: Angelo
authors.initials: A
authors.lastname: Ferrara
authors.forename: Mario
authors.initials: M
authors.lastname: Annecchiarico
authors.forename: Andrea
authors.initials: A
authors.lastname: Coratti
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome