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Delaying Chemotherapy After Surgery

Does it hurt to delay chemotherapy after surgery for stage II and III colon cancer?

A new study says it does.

Waiting more than 2 months, doubles the risk that patients will die. 

When adjuvant chemotherapy was delayed more than 60 days past surgery, patients were more likely to die within five years.  However, there wasn’t a significant decrease in relapse-free survival.

Doctors at the Sylvester Comprehensive Cancer Center at the University of Miami in Florida reviewed information on 186 stage II and III patients, 49 (26 percent) of whom started chemotherapy more than 60 days after their surgery.  Thirty percent of those cases were system-related:  late referrals or insurance issues, for instance.

The relative risk of dying within five years (overall survival) was 2.17 — a little over double that of patients who began their chemo earlier.

Recurrence-free survival favored patients with earlier chemo, but wasn’t statistically significant.

Ulas Darda Bayraktar, MD and the Sylvester team concluded,

Adjuvant chemotherapy delay >60 days after surgical resection of colon cancer is associated with worse overall survival.

SOURCE: Bayraktar et al., Cancer, Early View, December 17,  2010.

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