Surgical Complications Are Associated With Omission of Chemotherapy for Stage III Colorectal Cancer

Hendren, Samantha; Birkmeyer, John D.; Yin, Huiying; Banerjee, Mousumi; Sonnenday, Christopher J.; Morris, Arden M.

doi:10.1007/dcr.0b013e3181f2f202

Cited by 108 publications

(73 citation statements)

References 19 publications

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“…The application of chemotherapy prior to operative resection is associated with several advantages. The rate of all patients starting and completing the chemotherapy is higher in the neoadjuvant setting [13], and tumor regression is observed and the rate of local recurrence is reduced, for example, in rectal cancer [6]. Also, cases of complete pathological response are reported, without any tumor detection after neoadjuvant therapy [14].…”

Section: Discussionmentioning

confidence: 95%

Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy

Wiegering

Kunz

Hussein

et al. 2015

Int J Colorectal Dis

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Section: Discussionmentioning

confidence: 95%

Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy

Wiegering

Kunz

Hussein

et al. 2015

Int J Colorectal Dis

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“…Nearly 25% of respondents experienced complications after surgery-a rate consistent with most other series. [20][21][22][23] Survey respondents who reported complications experienced longer time off work and were more likely to never resume working. They were more likely to cut back on spending for food, clothes, and recreation and to accumulate debt or be unable to pay bills.…”

Section: Discussionmentioning

confidence: 99%

The personal financial burden of complications after colorectal cancer surgery

Regenbogen

Veenstra

Hawley

et al. 2014

Cancer

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BACKGROUND:Patients with colorectal cancer (CRC) may suffer significant economic hardship during treatment. Complications are common after surgery for CRC and may exacerbate the financial burden of CRC even further. METHODS: Within a population-based survey of patients with stage III CRC, the authors investigated the effects of disease and treatment on personal finances and computed a composite measure of financial burden. Correlations were examined between components of financial burden and patientreported postoperative complications using chi-square analyses, and Mantel-Haenszel chi-square tend tests were used to evaluate correlations between composite financial burden scores and surgical complications, controlling for patient characteristics and other factors by using multivariable Poisson regression. RESULTS: Among 937 respondents, 224 (24%) reported complications after surgery. Those with complications had significantly higher composite financial burden (P <.001 for trend): they were more likely to spend savings (40% vs 31%; P 5.01), borrow or take loans (18% vs 11%; P 5.007), fail to make credit card payments (18% vs 11%; P 5.005), reduce spending for food or clothes (38% vs 27%; P 5.001), and decrease recreational activities (41% vs 33%; P 5.03). They took significantly longer to return to work (P 5.009) and were more likely to experience significant worry about finances (61% vs 52%; P 5.01). CONCLUSIONS: Complications after surgery for CRC result in significant personal financial consequences as well as morbidity. Financial stress impairs quality of life and may prevent adherence to recommended treatments. Therefore, patients who suffer complications may require not just additional clinical care but also economic support and services. Cancer 2014;120:3074-81.

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“…In addition, increase in the length of postoperative hospital stay independently predicted delay in adjuvant chemotherapy as well. Hendren et al 13 also examined surgical complications and their association with omission of chemotherapy for Stage III colorectal cancer. Adjuvant chemotherapy was omitted in 46% of patient with complications, compared to 31% of patients without complications (P<0.001).…”

Section: Discussionmentioning

confidence: 99%

“…12–13 Delays in adjuvant chemotherapy were correlated with poorer disease-specific and overall survival in one of these studies. 12 Postoperative length of stay has also been shown to independently predict adjuvant chemotherapy delay in cancer patients.…”

mentioning

confidence: 94%

Adverse Effects of Smoking on Postoperative Outcomes in Cancer Patients

Gajdos¹,

et al. 2011

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Background The possible negative effects of smoking on postoperative outcomes have not been well-studied in cancer patients. Methods We used the VA Surgical Quality Improvement Program (VASQIP) database for the years 2002–2008, which assesses pre-operative risk factors and post-operative outcomes for patients undergoing major surgery within the VA healthcare system. Results Compared to never smokers, prior smokers and current smokers with GI malignancies were significantly more likely to have surgical site infection (SSI)( Odds ratio, OR:1.25, 95%CI:1.09–1.44)(OR:1.20, 95%CI:1.05–1.38), combined pulmonary complications (CPO: pneumonia, failure to wean from ventilator, reintubation) (OR:1.60, 95%CI:1.38–1.87)(OR:1.96, 95%CI:1.68–2.29) and return to the operating room (OR:1.20, 95%CI:1.03–1.39)(OR:1.31 95%CI:1.13–1.53), respectively. Both prior and current smokers had a significantly higher mortality at 30 days (OR:1.50, 95%CI:1.19–1.89)(OR: 1.41, 95%CI:1.08–1.82) and one year (OR:1.22, 95%CI:1.08–1.38)(OR:1.62, 95%C I:1.43–1.85). Thoracic surgery patients who were current smokers were more likely to develop CPO (OR:1.62, 95%CI:1.25–2.11), and mortality within one year (OR:1.50, 95%CI:1.17–1.92) compared to non-smokers, but SSI rates were not affected by smoking status. Current smokers had a significant increase in postsurgical length of stay (overall 4.3% [p<0.001], GI 4.7% [p=0.003], thoracic 9.0% [p<0.001]) compared to prior smokers. Conclusions Prior and current smoking status is a significant risk factor for major postoperative complications and mortality following GI cancer and thoracic operations in veterans. Smoking cessation should be encouraged prior to all major cancer surgery in the VA population to decrease postoperative complications and length of stay.

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Surgical Complications Are Associated With Omission of Chemotherapy for Stage III Colorectal Cancer

Cited by 108 publications

References 19 publications

Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy

Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy

The personal financial burden of complications after colorectal cancer surgery

Adverse Effects of Smoking on Postoperative Outcomes in Cancer Patients

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