Maud T A Strous1, Maryska L G Janssen-Heijnen2, F Jeroen Vogelaar3. 1. Department of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, the Netherlands. 2. Department of Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, the Netherlands; Department of Epidemiology, Maastricht University Medical Center+, GROW School for Oncology and Developmental Biology, Maastricht, the Netherlands. 3. Department of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, the Netherlands. Electronic address: jvogelaar@viecuri.nl.
Abstract
INTRODUCTION: Interest in adoption of a prehabilitation programme in management of colorectal cancer is increasing, but current waiting time targets leave no opening for intervention. Prompt treatment following diagnosis is demanded but defending evidence is lacking. We aimed to investigate the impact of prolonged therapeutic delay on overall and cancer-free survival in patients with primary colorectal cancer. METHODS: Retrospective analysis was performed in a detailed dataset of patients with primary colorectal cancer who underwent curative surgical treatment between January 2010 and December 2016. Groups were made according to therapeutic delay ≤35 days or >35 days. Endpoints were overall and cancer-free survival, assessed with Kaplan-Meier survival curves, log-rank tests and Cox proportional hazard analyses. RESULTS: A total of 790 patients were included of whom 559 had a colonic tumour and 231 a rectal tumour. Median therapeutic delay was 32 days (IQR 26-43 days). Multivariate analysis showed therapeutic delay >35 days was not associated with poorer overall survival (HR = 1.202, p = 0.249) or earlier cancer recurrence (HR = 1.256, p = 0.212). Similar results were found when stratifying analyses for colonic and rectal cancer, and when defining prolonged delay as >49 days. CONCLUSION: Prolonged treatment delay does not lead to poorer overall or cancer-free survival in patients with primary colorectal cancer who underwent curative surgical treatment. This allows professionals to push current national waiting time targets in order to adopt a prehabilitation programme without jeopardizing outcomes.
INTRODUCTION: Interest in adoption of a prehabilitation programme in management of colorectal cancer is increasing, but current waiting time targets leave no opening for intervention. Prompt treatment following diagnosis is demanded but defending evidence is lacking. We aimed to investigate the impact of prolonged therapeutic delay on overall and cancer-free survival in patients with primary colorectal cancer. METHODS: Retrospective analysis was performed in a detailed dataset of patients with primary colorectal cancer who underwent curative surgical treatment between January 2010 and December 2016. Groups were made according to therapeutic delay ≤35 days or >35 days. Endpoints were overall and cancer-free survival, assessed with Kaplan-Meier survival curves, log-rank tests and Cox proportional hazard analyses. RESULTS: A total of 790 patients were included of whom 559 had a colonic tumour and 231 a rectal tumour. Median therapeutic delay was 32 days (IQR 26-43 days). Multivariate analysis showed therapeutic delay >35 days was not associated with poorer overall survival (HR = 1.202, p = 0.249) or earlier cancer recurrence (HR = 1.256, p = 0.212). Similar results were found when stratifying analyses for colonic and rectal cancer, and when defining prolonged delay as >49 days. CONCLUSION: Prolonged treatment delay does not lead to poorer overall or cancer-free survival in patients with primary colorectal cancer who underwent curative surgical treatment. This allows professionals to push current national waiting time targets in order to adopt a prehabilitation programme without jeopardizing outcomes.
Authors: Charlotte J L Molenaar; Loes Janssen; Donald L van der Peet; Desmond C Winter; Rudi M H Roumen; Gerrit D Slooter Journal: World J Surg Date: 2021-04-03 Impact factor: 3.352
Authors: A K Warps; M P M de Neree Tot Babberich; E Dekker; M W J M Wouters; J W T Dekker; R A E M Tollenaar; P J Tanis Journal: Int J Colorectal Dis Date: 2021-03-20 Impact factor: 2.571
Authors: Thomas M Whittaker; Mohamed E G Abdelrazek; Aran J Fitzpatrick; Joseph L J Froud; Jack R Kelly; Jeremy S Williamson; Gethin L Williams Journal: Colorectal Dis Date: 2021-03-25 Impact factor: 3.917
Authors: Annefleur E M Berkel; Bart C Bongers; Hayke Kotte; Paul Weltevreden; Frans H C de Jongh; Michiel M M Eijsvogel; Machteld Wymenga; Marloes Bigirwamungu-Bargeman; Job van der Palen; Marc J van Det; Nico L U van Meeteren; Joost M Klaase Journal: Ann Surg Date: 2022-02-01 Impact factor: 13.787
Authors: Martin Busse; Ines Gockel; Roberto Falz; Christian Bischoff; René Thieme; Johannes Lässing; Matthias Mehdorn; Sigmar Stelzner Journal: J Cancer Res Clin Oncol Date: 2022-06-13 Impact factor: 4.322