Factors affecting use and delay (8 Weeks) of adjuvant chemotherapy after colorectal cancer surgery and the impact of chemotherapy-use and delay on oncologic outcomes

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Abstract

Purpose To evaluate factors affecting the use and delay 8 weeks of adjuvant chemotherapy and the impact of chemotherapy use and delay on survival. Methods Between 2005 and 2012, consecutive patients with stage II and III colorectal cancer who were treated with major curative resection were enrolled. Results Among 750 patients with stage II (n = 318) and III (n = 432) disease, 153 (20.4%) did not receive chemotherapy. Among 597 patients with adjuvant chemotherapy, 31 (5.2%) began chemotherapy 8 weeks or more after surgery. Factors associated with not receiving chemotherapy were: age 80 years (hazard ratio [HR] = 5.2), American Society of Anesthesiologists score 3 (HR = 1.9), underlying cerebrovascular disease (HR = 1.7), stage II disease (HR = 2.0), presence of postoperative complications (HR = 2.2), or intensive care unit admission (HR = 2.4). Factors associated with chemotherapy delay 8 weeks were: male sex (HR = 4.2), rectal primary cancer (HR = 5.4), or presence of postoperative complications (HR = 2.5). Independent prognostic factors for overall survival included TNM III stage (HR = 2.04) and chemotherapy delay 8 weeks (HR = 0.39) or <8 weeks (HR = 0.22). Independent prognostic factors for recurrence-free survival were TNM III stage (HR = 2.26) and chemotherapy delay <8 weeks (HR = 0.35). Conclusions Postoperative complications were associated with both lack of and delayed chemotherapy. Timely initiation of chemotherapy, defined as <8 weeks, was a favorable prognostic factor for overall and recurrence-free survival. To increase the proportion of patients receiving chemotherapy and timely initiation of chemotherapy, surgical complications should be minimized after curative resection.

Original languageEnglish
Article numbere0138720.
JournalPloS one
Volume10
Issue number9
DOIs
Publication statusPublished - 2015 Sep 18

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Colorectal Surgery
Chemotherapy
Adjuvant Chemotherapy
colorectal neoplasms
Surgery
drug therapy
adjuvants
Colorectal Neoplasms
Hazards
surgery
Drug Therapy
postoperative complications
Survival
resection
Cerebrovascular Disorders
Recurrence
cerebrovascular disorders
Sex Ratio
Rectal Neoplasms
Intensive care units

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{30f833fe2c334c3a9370ab2c728e6d23,
title = "Factors affecting use and delay (8 Weeks) of adjuvant chemotherapy after colorectal cancer surgery and the impact of chemotherapy-use and delay on oncologic outcomes",
abstract = "Purpose To evaluate factors affecting the use and delay 8 weeks of adjuvant chemotherapy and the impact of chemotherapy use and delay on survival. Methods Between 2005 and 2012, consecutive patients with stage II and III colorectal cancer who were treated with major curative resection were enrolled. Results Among 750 patients with stage II (n = 318) and III (n = 432) disease, 153 (20.4{\%}) did not receive chemotherapy. Among 597 patients with adjuvant chemotherapy, 31 (5.2{\%}) began chemotherapy 8 weeks or more after surgery. Factors associated with not receiving chemotherapy were: age 80 years (hazard ratio [HR] = 5.2), American Society of Anesthesiologists score 3 (HR = 1.9), underlying cerebrovascular disease (HR = 1.7), stage II disease (HR = 2.0), presence of postoperative complications (HR = 2.2), or intensive care unit admission (HR = 2.4). Factors associated with chemotherapy delay 8 weeks were: male sex (HR = 4.2), rectal primary cancer (HR = 5.4), or presence of postoperative complications (HR = 2.5). Independent prognostic factors for overall survival included TNM III stage (HR = 2.04) and chemotherapy delay 8 weeks (HR = 0.39) or <8 weeks (HR = 0.22). Independent prognostic factors for recurrence-free survival were TNM III stage (HR = 2.26) and chemotherapy delay <8 weeks (HR = 0.35). Conclusions Postoperative complications were associated with both lack of and delayed chemotherapy. Timely initiation of chemotherapy, defined as <8 weeks, was a favorable prognostic factor for overall and recurrence-free survival. To increase the proportion of patients receiving chemotherapy and timely initiation of chemotherapy, surgical complications should be minimized after curative resection.",
author = "Kim, {Ik Yong} and Kim, {Bo Ra} and Kim, {Young Wan}",
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T1 - Factors affecting use and delay (8 Weeks) of adjuvant chemotherapy after colorectal cancer surgery and the impact of chemotherapy-use and delay on oncologic outcomes

AU - Kim, Ik Yong

AU - Kim, Bo Ra

AU - Kim, Young Wan

PY - 2015/9/18

Y1 - 2015/9/18

N2 - Purpose To evaluate factors affecting the use and delay 8 weeks of adjuvant chemotherapy and the impact of chemotherapy use and delay on survival. Methods Between 2005 and 2012, consecutive patients with stage II and III colorectal cancer who were treated with major curative resection were enrolled. Results Among 750 patients with stage II (n = 318) and III (n = 432) disease, 153 (20.4%) did not receive chemotherapy. Among 597 patients with adjuvant chemotherapy, 31 (5.2%) began chemotherapy 8 weeks or more after surgery. Factors associated with not receiving chemotherapy were: age 80 years (hazard ratio [HR] = 5.2), American Society of Anesthesiologists score 3 (HR = 1.9), underlying cerebrovascular disease (HR = 1.7), stage II disease (HR = 2.0), presence of postoperative complications (HR = 2.2), or intensive care unit admission (HR = 2.4). Factors associated with chemotherapy delay 8 weeks were: male sex (HR = 4.2), rectal primary cancer (HR = 5.4), or presence of postoperative complications (HR = 2.5). Independent prognostic factors for overall survival included TNM III stage (HR = 2.04) and chemotherapy delay 8 weeks (HR = 0.39) or <8 weeks (HR = 0.22). Independent prognostic factors for recurrence-free survival were TNM III stage (HR = 2.26) and chemotherapy delay <8 weeks (HR = 0.35). Conclusions Postoperative complications were associated with both lack of and delayed chemotherapy. Timely initiation of chemotherapy, defined as <8 weeks, was a favorable prognostic factor for overall and recurrence-free survival. To increase the proportion of patients receiving chemotherapy and timely initiation of chemotherapy, surgical complications should be minimized after curative resection.

AB - Purpose To evaluate factors affecting the use and delay 8 weeks of adjuvant chemotherapy and the impact of chemotherapy use and delay on survival. Methods Between 2005 and 2012, consecutive patients with stage II and III colorectal cancer who were treated with major curative resection were enrolled. Results Among 750 patients with stage II (n = 318) and III (n = 432) disease, 153 (20.4%) did not receive chemotherapy. Among 597 patients with adjuvant chemotherapy, 31 (5.2%) began chemotherapy 8 weeks or more after surgery. Factors associated with not receiving chemotherapy were: age 80 years (hazard ratio [HR] = 5.2), American Society of Anesthesiologists score 3 (HR = 1.9), underlying cerebrovascular disease (HR = 1.7), stage II disease (HR = 2.0), presence of postoperative complications (HR = 2.2), or intensive care unit admission (HR = 2.4). Factors associated with chemotherapy delay 8 weeks were: male sex (HR = 4.2), rectal primary cancer (HR = 5.4), or presence of postoperative complications (HR = 2.5). Independent prognostic factors for overall survival included TNM III stage (HR = 2.04) and chemotherapy delay 8 weeks (HR = 0.39) or <8 weeks (HR = 0.22). Independent prognostic factors for recurrence-free survival were TNM III stage (HR = 2.26) and chemotherapy delay <8 weeks (HR = 0.35). Conclusions Postoperative complications were associated with both lack of and delayed chemotherapy. Timely initiation of chemotherapy, defined as <8 weeks, was a favorable prognostic factor for overall and recurrence-free survival. To increase the proportion of patients receiving chemotherapy and timely initiation of chemotherapy, surgical complications should be minimized after curative resection.

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