Abstract
AimsAdjuvant chemotherapy is recommended for patients with curatively resected colorectal cancer. The aim of this study is to evaluate the impact of unmet supportive care needs and anxiety on the initiation of postoperative adjuvant chemotherapy in colorectal cancer patients.MethodsThis is a retrospective study from a single tertiary referral hospital. Patients diagnosed with colorectal cancer who met the inclusion criteria were included. The Hospital Anxiety and Depression Scale (HADS) and modified 34-item Supportive Care Needs Survey (SCNS-SF34) were applied to assess patient’s anxiety level and unmet needs. The time intervals between initiation of adjuvant chemotherapy and operation were recorded. Factors associated with delayed initiation of chemotherapy were investigated in univariate and multivariate analysis.ResultsA total of 135 patients with colorectal cancer were included. In total, 16.3% (22/135) and 5.2% (7/135) reported symptoms of anxiety and depression. In multivariate analysis, low to moderate income status, postoperative complications, anxiety, and high level of unmet needs are independent risk factors for late initiation of chemotherapy.ConclusionsOur findings showed that psychological problems such as anxiety and high unmet supportive needs are correlated with delayed initiation of adjuvant chemotherapy in colorectal cancer patients.
Highlights
Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer death in the world [1]
Our results demonstrated that low unmet needs status is significantly correlated with early initiation of adjuvant chemotherapy (AC) (HR = 4.162) while high unmet supportive needs is an independent risk factor for delayed initiation AC (HR = 2.905)
Smooth transition to postoperative adjuvant chemotherapy is critical in colorectal cancer treatment
Summary
Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer death in the world [1]. A systematic and meta-analysis involving 15,410 colorectal patients demonstrated that a 4-week increment in time to adjuvant chemotherapy was associated with a 14% decrease in both overall survival (OS) and disease-free survival (DFS) [6]. Another two large-scale retrospective studies from the US and Netherlands National Cancer Database showed that a delay of 6–8 weeks between surgery and adjuvant therapy would reduce survival in stage II and III colorectal cancer patients [7, 8].
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