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Medline ® Abstract for Reference 22

of 'Adjuvant therapy for resected stage III (node-positive) colon cancer'

Adjuvant chemotherapy for stage III colon cancer: does timing matter?
Czaykowski PM, Gill S, Kennecke HF, Gordon VL, Turner D
Dis Colon Rectum. 2011;54(9):1082.
BACKGROUND: Clinical trials commonly mandate that adjuvant chemotherapy for colon cancer should commence within 8 weeks (56 days) of surgery.
OBJECTIVE: We investigated the consequences of the timing of adjuvant chemotherapy for stage III colon cancer.
PATIENTS AND METHODS: This is a retrospective review of all patients with newly diagnosed stage III colon cancer who received adjuvant chemotherapy in 2 provincial centers in 1999 and 2000. The impact of time to adjuvant chemotherapy on overall survival and relapse-free survival was analyzed by the use of univariate and multivariate Cox modeling, adjusting for prognostic factors.
RESULTS: Three hundred forty-five subjects were included. Median time to adjuvant chemotherapy was 50 days (range, 20-242 days); in 111 (32.2%) patients, it was beyond 56 days. On univariate analysis, time>56 days was nonsignificantly associated with a hazard ratio of death of 1.31 (P = .12). Similar results were seen for relapse-free survival.Planned exploratory analysis suggests that the commencement of adjuvant chemotherapy up to 10 weeks postsurgery still confers a benefit.
CONCLUSIONS: Delaying adjuvant chemotherapy in stage III colon cancer beyond 8 to 10 weeks postsurgery appears to be associated with diminished benefit.
Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada. Piotr.czaykowski@cancercare.mb.ca