Time to adjuvant chemotherapy following colorectal cancer resection is associated with an improved survival

Abstract

Multicentre randomized trials have demonstrated equivalent long-term outcomes for open and laparoscopic resection of colon cancer. Some studies have indicated a possible survival advantage in certain patients undergoing laparoscopic resection. Patients who receive adjuvant chemotherapy in <8weeks following surgery can have an improved survival. Data were collated for patients having an elective laparoscopic or open resection for non-metastatic colorectal cancer between October 2003 and December 2010 and subsequently having adjuvant chemotherapy. Survival analysis was conducted. In all, 209 patients received adjuvant chemotherapy following open (n=76) or laparoscopic (n=133) surgery. Median length of stay was 3days with laparoscopic resection and 6days with open resection (P<0.0005). Median number of days to initiation of adjuvant chemotherapy was 52 with laparoscopic resection and 58 with open resection (P=0.008). The 5-year overall survival was 89.6% in patients receiving chemotherapy in <8weeks after surgery, compared with 73.5% who started the treatment over 8weeks (P=0.016). The 5-year overall survival for those patients with a laparoscopic resection was 82.3% compared with 80.3% with an open resection (P=0.049). There is an overall survival advantage when patients receive adjuvant chemotherapy <8weeks after surgery. Laparoscopic resection allows earlier discharge and, subsequently, earlier initiation of adjuvant chemotherapy.