Improved survival with early adjuvant chemotherapy after colonic resection for stage III colonic cancer: A nationwide study

Abstract

Survival increased when adjuvant therapy was started within 8 weeks after surgery for stage III colonic cancer.

Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer

“…Recommendations from clinical trials (including the GOG 92 study) for timely adjuvant therapy (within 4 to 6 weeks postoperatively) have been suggested, however no published scientific or clinical data support an exact time frame yet [17]. The conceptual role of adjuvant therapy after complete surgical resection is to control residual subclinical disease [3918]. The TI from surgery to adjuvant therapy may provide an opportunity for micrometastases to proliferate.…”

“…Data from several animal model studies suggest that surgery may lead to early accelerated growth of micrometastases and the stimulation of angiogenesis by the release of circulating growth factors or reduction in angiogenesis inhibitors (such as angiostatin) [91920]. Furthermore, the stress response after surgery might induce a favorable environment for cancer progression in the early postoperative phase [1821]. So, it seems logical that early initiation of adjuvant therapy might increase the chances of eliminating any residual tumor cells before they have an opportunity to begin metastasizing, and, thereby, obtain improved oncological outcomes.…”

“…Bos et al [25] reported that factors associated with starting treatment after 8 weeks in 6,620 patients with stage III colon cancer were older age, emergency resection, anastomotic leakage, referral to another hospital for adjuvant chemotherapy, and prolonged postoperative stay. Recently, another study found that laparoscopic surgery increased the chance of early adjuvant therapy in colonic cancer [18]. …”

Use of guideline‐recommended adjuvant therapies and survival outcomes for people with colorectal cancer at tertiary referral hospitals in South Australia

“…The optimal time interval from surgery to start of adjuvant therapy has been evaluated in trials, with conflicting results. Recent studies and a meta‐analysis suggest worse outcomes when adjuvant therapy for stage C colon cancer is delayed for more than 8 to 12 weeks . Delayed initiation of adjuvant therapy is now being used as a key quality measure of care in Australia .…”

The effect of a simultaneous versus a staged resection of metastatic colorectal cancer on time to adjuvant chemotherapy

“…The timing of chemotherapy in patients undergoing curative resection of colorectal liver metastases is not well understood . It has been shown that a delay in the initiation of adjuvant chemotherapy in patients with stage II and III colorectal cancers results in a decreased OS . Chemotherapy and surgical treatment have been studied in isolation; however, it is important to consider how these treatment modalities interact and influence one another.…”