Does delay of adjuvant chemotherapy impact survival in patients with resected stage ii and iii colon adenocarcinoma?

Ulas Darda Bayraktar, Emerson Chen, Soley Bayraktar, Laurence Sands, Floriano Marchetti, Alberto Jose Montero, Caio Max S Rocha-Lima

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)2364-2370
Number of pages7
JournalCancer
Volume117
Issue number11
DOIs
StatePublished - Jun 1 2011

Fingerprint

Adjuvant Chemotherapy
Colon
Adenocarcinoma
Survival
Proportional Hazards Models
Recurrence
Insurance
Ambulatory Surgical Procedures
Colonic Neoplasms
Registries
Referral and Consultation
Multivariate Analysis
Confidence Intervals
Neoplasms

Keywords

  • 5-fluorouracil
  • Adjuvant chemotherapy
  • Cancer therapy delay
  • Colon cancer
  • Disparity
  • Oxaliplatin

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Does delay of adjuvant chemotherapy impact survival in patients with resected stage ii and iii colon adenocarcinoma? / Bayraktar, Ulas Darda; Chen, Emerson; Bayraktar, Soley; Sands, Laurence; Marchetti, Floriano; Montero, Alberto Jose; Rocha-Lima, Caio Max S.

In: Cancer, Vol. 117, No. 11, 01.06.2011, p. 2364-2370.

Research output: Contribution to journalArticle

Bayraktar, Ulas Darda ; Chen, Emerson ; Bayraktar, Soley ; Sands, Laurence ; Marchetti, Floriano ; Montero, Alberto Jose ; Rocha-Lima, Caio Max S. / Does delay of adjuvant chemotherapy impact survival in patients with resected stage ii and iii colon adenocarcinoma?. In: Cancer. 2011 ; Vol. 117, No. 11. pp. 2364-2370.
@article{f40f890403f24934bce216143f91ed58,
title = "Does delay of adjuvant chemotherapy impact survival in patients with resected stage ii and iii colon adenocarcinoma?",
abstract = "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.",
keywords = "5-fluorouracil, Adjuvant chemotherapy, Cancer therapy delay, Colon cancer, Disparity, Oxaliplatin",
author = "Bayraktar, {Ulas Darda} and Emerson Chen and Soley Bayraktar and Laurence Sands and Floriano Marchetti and Montero, {Alberto Jose} and Rocha-Lima, {Caio Max S}",
year = "2011",
month = "6",
day = "1",
doi = "10.1002/cncr.25720",
language = "English",
volume = "117",
pages = "2364--2370",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "11",

}

TY - JOUR

T1 - Does delay of adjuvant chemotherapy impact survival in patients with resected stage ii and iii colon adenocarcinoma?

AU - Bayraktar, Ulas Darda

AU - Chen, Emerson

AU - Bayraktar, Soley

AU - Sands, Laurence

AU - Marchetti, Floriano

AU - Montero, Alberto Jose

AU - Rocha-Lima, Caio Max S

PY - 2011/6/1

Y1 - 2011/6/1

N2 - 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.

AB - 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.

KW - 5-fluorouracil

KW - Adjuvant chemotherapy

KW - Cancer therapy delay

KW - Colon cancer

KW - Disparity

KW - Oxaliplatin

UR - http://www.scopus.com/inward/record.url?scp=79958049939&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958049939&partnerID=8YFLogxK

U2 - 10.1002/cncr.25720

DO - 10.1002/cncr.25720

M3 - Article

C2 - 24048783

AN - SCOPUS:79958049939

VL - 117

SP - 2364

EP - 2370

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 11

ER -