Single institution experience: Factors influencing timing of adjuvant chemotherapy in early stage colorectal cancer. — ASN Events
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Single institution experience: Factors influencing timing of adjuvant chemotherapy in early stage colorectal cancer. (#8)

Bhaskar Karki 1 , Jasotha Sanmugarajah 1
  1. GCH, Gold Coast, QLD, Australia

Title:

Factors influencing timing of adjuvant chemotherapy in early stage colorectal cancer: An Australian Public Hospital Experience.

Background:

Adjuvant chemotherapy for early stage colorectal cancer improves disease free and overall survival. Adjuvant trials mandate that the treatment start within 8 weeks of surgery. Although no prospective studies have established the optimum timing of adjuvant treatment, retrospective studies indicate that delay in treatment may have not have benefit or worse outcome.

Objective:

To see the timing of adjuvant chemotherapy for resected colorectal carcinoma in our institution and identify the factors that may have affected in the delay of starting treatment.

Methods:

Retrospective review of electronic record of patients treated between January 2011 to January 2013 with adjuvant chemotherapy for early stage colorectal-cancer. Delayed start   was defined as starting after 8 weeks from surgical resection. In this group we tried to find the factors that may have contributed to delay in starting treatment.

Results:

Between January 2011 and January 2013, 70 patients received adjuvant chemotherapy for stage II (24%) and stage III (76%) colorectal carcinoma. Mean age was 63 years. 80 %( 56) started within 8 weeks from surgery and of this 50 %( 28) within 6 weeks. In the delayed group the mean age was 61 years. Surgical complication was the main reason for delay (8). The other reasons were, delayed decision by patients (2), dental abscess (1), delayed oncology appointment (1), MDT re-discussion (1) and in one patient patient the reason couldn't be identified.

Discussion:

Clinical trial mandates that adjuvant chemotherapy start within 6-8 weeks. In clinical practice it is started when patients have recovered from surgery. In our audit, we found that most patients started within 8 weeks. Surgical complication was the major reason for delay. The tumour stage or age didn't contribute to delay starting.


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