Post-surgery complications can affect chemotherapy treatment after surgery in colorectal cancer

This study investigated the post-surgery factors that affect the use of chemotherapy after surgery in colorectal cancer patients. Researchers suggested that post-surgery complications are associated with delay or not receiving chemotherapy treatment.  

Surgery and post-surgery chemotherapy are the standard treatment for colorectal cancer. The post-surgery treatment decreases the risk of cancer recurrence (when the cancer comes back). Treatment guidelines recommend starting the chemotherapy treatment up to 8 weeks after the surgery. However, the post-surgery factors that can affect starting the chemotherapy are not well studied.    

The objective of this study was to evaluate the factors that can affect the starting of chemotherapy after surgery in colorectal cancer patients.

This study included information about 750 patients with stage 2 (318) and stage 3 (432) colorectal cancer. Of this 153 did not receive chemotherapy. Of the 597 that received treatment, 31 (5.2%) started the treatment 8 weeks or more after the surgery.

Patients who were 80 years of age or more were 5.2 times more at risk for not receiving chemotherapy, as well as patients with cerebrovascular disease (1.7 times), patients with stage 2 cancer (2 times) and patients with post-surgery complications (2.2 times).

Patients with post-surgery complications were 2.5 times more at risk of starting chemotherapy after 8 weeks.  Males were 4.2 times more likely to start chemotherapy after 8 weeks.

5 year overall survival (time from treatment to death from any cause) was 80.1% for those who started chemotherapy before 8 weeks, 56.5% in those who started after 8 weeks, and 39.4% in those who did not undergo chemotherapy. Recurrence free survival was also highest in those treated before 8 weeks.

This study showed that post-surgery complications were associated with both not receiving and delay of chemotherapy. The study suggested that earlier chemotherapy was associated with better outcomes.