1Department of Surgery, University of Wisconsin, Madison, Wisconsin 2School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
Dis Colon Rectum. 2013 Dec;56(12):1339-48. doi: 10.1097/DCR.0b013e3182a857eb.
The objective of this study was to identify the risk factors for delays in chemotherapy after rectal cancer surgery and evaluate the effects of delayed therapy on long-term outcomes. We also sought to clarify what time frame should be used to define delayed adjuvant chemotherapy.
Postoperative complications have been found to influence the timing of chemotherapy in patients with colon cancer. Delays in chemotherapy have been shown to be associated with worse overall and disease-free survival in patients with colorectal cancer, although the timing of delay has not been agreed upon in the literature.
We performed a retrospective review of a prospectively maintained rectal cancer database. Univariate analysis was used to identify risk factors for delayed chemotherapy. Kaplan-Meier curves were generated to compare overall and disease-free survival in patients based on complications and timing of chemotherapy.
This study was performed at the University of Wisconsin Hospital, Madison, Wisconsin, between 1995 and 2012.
Patients with rectal cancer who underwent proctectomy with curative intent were included in this study.
Timing of chemotherapy, 30-day complications, and 30-day readmissions were the main outcome measures.
Postoperative complications and 30-day readmissions were associated with delays in chemotherapy ≥8 weeks after surgery. Patients who received chemotherapy ≥8 weeks postoperatively were found to have worse local and distant recurrence rates and worse overall survival in comparison with patients who received chemotherapy within 8 weeks of surgery.
The limitations of this study include its retrospective nature and that it was performed at a single institution.
We found complications and readmissions to be risk factors for delayed chemotherapy. Patients who received therapy ≥8 weeks postoperatively had worse disease-free and overall survival.
本研究旨在确定直肠癌手术后化疗延迟的风险因素，并评估延迟治疗对长期结局的影响。我们还试图阐明应该使用什么时间框架来定义延迟辅助化疗。
术后并发症已被发现会影响结肠癌患者的化疗时间。尽管文献中尚未就延迟时间达成一致，但化疗延迟已被证明与结直肠癌患者的总生存率和无病生存率较差相关。
我们对一个前瞻性维持的直肠癌数据库进行了回顾性研究。单因素分析用于确定化疗延迟的风险因素。生成 Kaplan-Meier 曲线，根据并发症和化疗时间比较患者的总生存率和无病生存率。
本研究在威斯康星大学医院进行，威斯康星州麦迪逊，1995 年至 2012 年。
接受根治性直肠切除术的直肠癌患者纳入本研究。
化疗时间、30 天并发症和 30 天再入院是主要观察指标。
术后并发症和 30 天再入院与术后≥8 周化疗延迟有关。与术后 8 周内接受化疗的患者相比，接受术后≥8 周化疗的患者局部和远处复发率更高，总生存率更差。
本研究的局限性包括其回顾性性质和在单一机构进行。
我们发现并发症和再入院是化疗延迟的危险因素。术后接受治疗≥8 周的患者无病生存率和总生存率更差。
