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Time to adjuvant chemotherapy following colorectal cancer resection is associated with an improved survival
Author(s) -
Day A. R.,
Middleton G.,
Smith R. V. P.,
Jourdan I. C.,
Rockall T. A.
Publication year - 2014
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12570
Subject(s) - medicine , colorectal cancer , chemotherapy , adjuvant , surgery , adjuvant chemotherapy , laparoscopic surgery , randomized controlled trial , laparoscopy , cancer , breast cancer
Aim Multicentre randomized trials have demonstrated equivalent long‐term outcomes for open and laparoscopic resection of colon cancer. Some studies have indicated a possible survival advantage in certain patients undergoing laparoscopic resection. Patients who receive adjuvant chemotherapy in < 8 weeks following surgery can have an improved survival. Method Data were collated for patients having an elective laparoscopic or open resection for non‐metastatic colorectal cancer between October 2003 and December 2010 and subsequently having adjuvant chemotherapy. Survival analysis was conducted. Results In all, 209 patients received adjuvant chemotherapy following open ( n = 76) or laparoscopic ( n = 133) surgery. Median length of stay was 3 days with laparoscopic resection and 6 days with open resection ( P < 0.0005). Median number of days to initiation of adjuvant chemotherapy was 52 with laparoscopic resection and 58 with open resection ( P = 0.008). The 5‐year overall survival was 89.6% in patients receiving chemotherapy in < 8 weeks after surgery, compared with 73.5% who started the treatment over 8 weeks ( P = 0.016). The 5‐year overall survival for those patients with a laparoscopic resection was 82.3% compared with 80.3% with an open resection ( P = 0.049). Conclusion There is an overall survival advantage when patients receive adjuvant chemotherapy < 8 weeks after surgery. Laparoscopic resection allows earlier discharge and, subsequently, earlier initiation of adjuvant chemotherapy.