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Following colorectal cancer surgery, longer delay before chemotherapy associated with worse survival
Date:6/4/2011

An analysis of data from previously published studies indicates that longer time to beginning adjuvant chemotherapy after surgery for colorectal cancer is associated with worse survival, according to a study in the June 8 issue of JAMA, a theme issue on cancer. The study is being published early online to coincide with its presentation at the American Society of Clinical Oncology 2011 Annual Meeting.

"Colorectal cancer (CRC) is the third leading cause of cancer mortality in the Western world. While surgical resection [removal] remains the cornerstone of management for patients with stage I-III disease, a considerable proportion of patients will ultimately relapse and die from their disease," according to background information in the article. "Adjuvant chemotherapy [AC; chemotherapy after surgery] improves survival among patients with resected colorectal cancer. However, the optimal timing from surgery to initiation of AC is unknown." There is also a question of the benefit of beginning chemotherapy after a certain time period, typically believed to be 12 weeks.

James J. Biagi, M.D., of Queen's University, Kingston, Ontario, Canada, and colleagues conducted a review and meta-analysis of studies that assessed the relationship between time to AC and survival in CRC. Studies were only included if relevant prognostic factors were adequately described and either comparative groups were balanced or results adjusted for these prognostic factors. The researchers identified 10 eligible studies involving 15,410 patients (7 published articles, 3 abstracts) that met study criteria for inclusion. Nine of the studies were cohort or population based and 1 was a secondary analysis from a randomized trial of chemotherapy.

The researchers found that meta-analysis indicated that a 4-week increase in time to AC was associated with a significant decrease (14 percent) in both overall survival and disease-free survival. There was no significant hete
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Contact: Christina Archibald
christina.archibald@queensu.ca
613-533-2877
JAMA and Archives Journals
Source:Eurekalert

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