L V Dos Santos1,2, T M V Faria3, A B C Lima4, K C Abdalla3, E D de Moraes4, M R Cruz5, J P Lima6. 1. Instituto de Ensino e Pesquisa São Lucas, São Paulo, Brazil. 2. Internal Medicine Department, University of Campinas, São Paulo, Brazil. 3. Hospital do Câncer, Barretos, Brazil. 4. Núcleo de Oncologia da Bahia - Oncoclínicas do Brasil, Salvador, Brazil. 5. Centro Oncológico Antônio Ermírio de Moraes, São Paulo, Brazil. 6. Institute of Cancer Research, Royal Marsden Hospital, London, UK.
Abstract
AIM: Delay in commencing adjuvant therapy for colorectal cancer seems to impair survival in some retrospective studies. This study was planned to evaluate its impact on survival. METHODS: This was a retrospective study enrolling patients registered from 2000 to 2012 in two large cancer-dedicated institutions in Brazil. The primary outcome was overall survival according to early vs late chemotherapy initiation. The interval between the primary surgery and the start of adjuvant chemotherapy was calculated. Survival was estimated using the Kaplan-Meier method and the impact of multiple prognostic factors on survival by Cox regression analysis. RESULTS: By the end of 2012, a total of 1963 Stage II and III colorectal patients were identified and 1318 patients received adjuvant chemotherapy, with 22% and 46% of those starting adjuvant chemotherapy within 6 weeks and 8 weeks of surgery. The median period of follow-up was 41 months. Patients starting chemotherapy within 6-8 weeks of surgery had longer overall survival compared with those who started after (6 weeks vs later, hazard ratio 0.76, 95% CI 0.57-0.99, P = 0.046; 8 weeks vs later, hazard ratio 0.74, 95% CI 0.59-0.93, P = 0.011). In the multivariate analysis, age, stage, histological grade, angiolymphatic invasion, emergency surgery and preoperative therapy were independent prognostic factors, but the interval between surgery and start of adjuvant therapy was not. CONCLUSION: In this large retrospective study, the standard prognostic factors impacted on survival whereas the timing of adjuvant therapy did not. Patients with delayed adjuvant chemotherapy may have worse prognostic factors which could play a major role in their poor outcome. Colorectal Disease
AIM: Delay in commencing adjuvant therapy for colorectal cancer seems to impair survival in some retrospective studies. This study was planned to evaluate its impact on survival. METHODS: This was a retrospective study enrolling patients registered from 2000 to 2012 in two large cancer-dedicated institutions in Brazil. The primary outcome was overall survival according to early vs late chemotherapy initiation. The interval between the primary surgery and the start of adjuvant chemotherapy was calculated. Survival was estimated using the Kaplan-Meier method and the impact of multiple prognostic factors on survival by Cox regression analysis. RESULTS: By the end of 2012, a total of 1963 Stage II and III colorectalpatients were identified and 1318 patients received adjuvant chemotherapy, with 22% and 46% of those starting adjuvant chemotherapy within 6 weeks and 8 weeks of surgery. The median period of follow-up was 41 months. Patients starting chemotherapy within 6-8 weeks of surgery had longer overall survival compared with those who started after (6 weeks vs later, hazard ratio 0.76, 95% CI 0.57-0.99, P = 0.046; 8 weeks vs later, hazard ratio 0.74, 95% CI 0.59-0.93, P = 0.011). In the multivariate analysis, age, stage, histological grade, angiolymphatic invasion, emergency surgery and preoperative therapy were independent prognostic factors, but the interval between surgery and start of adjuvant therapy was not. CONCLUSION: In this large retrospective study, the standard prognostic factors impacted on survival whereas the timing of adjuvant therapy did not. Patients with delayed adjuvant chemotherapy may have worse prognostic factors which could play a major role in their poor outcome. Colorectal Disease
Authors: C A Farzaneh; A Pigazzi; W Q Duong; J C Carmichael; M J Stamos; F Dekhordi-Vakil; F Dayyani; J A Zell; M D Jafari Journal: Tech Coloproctol Date: 2022-08-30 Impact factor: 3.699
Authors: Yoontaek Lee; Sa-Hong Min; Ki Bum Park; Young Suk Park; Ji-Won Kim; Sang-Hoon Ahn; Jin Won Kim; Do Joong Park; Keun-Wook Lee; Hyung-Ho Kim Journal: J Gastric Cancer Date: 2018-03-20 Impact factor: 3.720
Authors: Francisco A Montiel Ishino; Emmanuel A Odame; Kevin Villalobos; Martin Whiteside; Hadii Mamudu; Faustine Williams Journal: J Public Health Manag Pract Date: 2022 Mar-Apr 01