Delay in adjuvant chemotherapy significantly decreases overall and disease-free survival in CRC
Monday, June 6, 2011 (Last Updated: 06/07/2011)
MONDAY, June 6 (HealthDay News) -- An increase in time to adjuvant chemotherapy is associated with a significant decrease in overall and disease-free survival in patients with colorectal cancer (CRC), according to a review published in the June 8 cancer-themed issue of the Journal of the American Medical Association to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 3 to 7 in Chicago.
James J. Biagi, M.D., from Queen's University in Kingston, Canada, and colleagues reviewed available literature to investigate the relationship between time to adjuvant chemotherapy and survival outcomes in CRC. Ten studies involving 15,410 patients (seven published articles and three abstracts) were included in the analysis. Publication bias and weight of individual studies was estimated. Overall and disease-free survival were the main outcomes studied.
The investigators found that a four-week increase in the time to adjuvant chemotherapy correlated with a significant reduction in both overall and disease-free survival (hazard ratio, 1.14 for both). No significant heterogeneity was identified among the included studies. The results remained significant after adjusting for potential publication bias and after repeating the analysis to exclude studies of largest weight.
"Our results demonstrate a significant adverse association between time to adjuvant chemotherapy and survival in CRC, supporting a position that clinicians and jurisdictions need to optimize patient flow logistics to minimize time to adjuvant chemotherapy," the authors write.
One of the study authors provided expert testimony in a class action suit on breast cancer in Quebec in 2009.
Hematology & Oncology
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