Cargando…

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

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 enroll...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Ik Yong, Kim, Bo Ra, Kim, Young Wan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575146/
https://www.ncbi.nlm.nih.gov/pubmed/26381146
http://dx.doi.org/10.1371/journal.pone.0138720
_version_ 1782390737451614208
author Kim, Ik Yong
Kim, Bo Ra
Kim, Young Wan
author_facet Kim, Ik Yong
Kim, Bo Ra
Kim, Young Wan
author_sort Kim, Ik Yong
collection PubMed
description 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.
format Online
Article
Text
id pubmed-4575146
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-45751462015-09-25 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 Kim, Ik Yong Kim, Bo Ra Kim, Young Wan PLoS One Research Article 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. Public Library of Science 2015-09-18 /pmc/articles/PMC4575146/ /pubmed/26381146 http://dx.doi.org/10.1371/journal.pone.0138720 Text en © 2015 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Kim, Ik Yong
Kim, Bo Ra
Kim, Young Wan
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575146/
https://www.ncbi.nlm.nih.gov/pubmed/26381146
http://dx.doi.org/10.1371/journal.pone.0138720
work_keys_str_mv AT kimikyong factorsaffectinguseanddelay8weeksofadjuvantchemotherapyaftercolorectalcancersurgeryandtheimpactofchemotherapyuseanddelayononcologicoutcomes
AT kimbora factorsaffectinguseanddelay8weeksofadjuvantchemotherapyaftercolorectalcancersurgeryandtheimpactofchemotherapyuseanddelayononcologicoutcomes
AT kimyoungwan factorsaffectinguseanddelay8weeksofadjuvantchemotherapyaftercolorectalcancersurgeryandtheimpactofchemotherapyuseanddelayononcologicoutcomes