Does Delay of Adjuvant Chemotherapy Impact Survival in Patients With Resected Stage II and III Colon Adenocarcinoma?
Does Delay of Adjuvant Chemotherapy Impact Survival in Patients With Resected Stage II and III Colon Adenocarcinoma?
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DOI：
10.1002/cncr.25720
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发表时间：
2011-06-01
期刊：
影响因子：
6.2
通讯作者：
Rocha-Lima, Caio Max S.
中科院分区：
文献类型：
--
作者：
Bayraktar, Ulas Darda;Chen, Emerson;Rocha-Lima, Caio Max S.
背景：尚不清楚结肠腺癌手术切除后延迟开始辅助化疗是否会对生存产生不利影响。方法：通过机构肿瘤登记处确定在 2 个中心接受辅助化疗的 II-III 期结肠腺癌患者。从手术当天开始计算辅助化疗时间、总生存期（OS）和无复发生存期（RFS）。患者被分为早期组（辅助化疗时间为 60 天）。使用对数秩检验和 Cox 比例风险模型的多变量分析来比较 OS 和 RFS。结果：在该研究纳入的 186 名患者中，49 名患者 (26%) 在手术切除后 60 天以上接受了辅助化疗。百分之三十的延迟与系统相关（例如，延迟转介、保险授权）。在单变量分析和 Cox 比例风险模型中，辅助化疗时间 > 60 天与显着较差的 OS 相关（风险比，2.17；95% 置信区间，1.08-4.36）。尽管两组之间的 RFS 差异有利于结肠癌手术切除后 60 天的辅助化疗时间，但与较差的 OS 相关。癌症2011； 117：2364-70。 (C) 2010 年美国癌症协会。
BACKGROUND: It is unclear whether delays in commencing adjuvant chemotherapy after surgical resection of colon adenocarcinoma adversely impact survival. METHODS: Patients with stage II-III colon adenocarcinoma who received adjuvant chemotherapy at 2 centers were identified through the institutional tumor registry. Time to adjuvant chemotherapy, overall survival (OS), and relapse-free survival (RFS) were calculated from the day of surgery. Patients were dichotomized into early (time to adjuvant chemotherapy 60 days) groups. OS and RFS were compared using log-rank test and multivariate analysis by the Cox proportional hazards model. RESULTS: Of 186 patients included in the study, 49 (26%) had received adjuvant chemotherapy >60 days after surgical resection. Thirty percent of the delays were system related (eg, late referrals, insurance authorizations). Time to adjuvant chemotherapy >60 days was associated with significantly worse OS in both univariate analysis and a Cox proportional hazards model (hazard ratio, 2.17; 95% confidence interval, 1.08-4.36). Although difference in RFS between the 2 groups favored time to adjuvant chemotherapy 60 days after surgical resection of colon cancer is associated with worse OS. Cancer 2011; 117:2364-70. (C) 2010 American Cancer Society.