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01-01-2020 | Rectal Cancer | 2019 SSAT Plenary Presentation

The Impact of Delays to Definitive Surgical Care on Survival in Colorectal Cancer Patients

Authors: Maude Trepanier, Tiffany Paradis, Araz Kouyoumdjian, Teodora Dumitra, Patrick Charlebois, Barry S. Stein, A. Sender Liberman, Kevin Schwartzman, Franco Carli, Gerald M. Fried, Liane S. Feldman, Lawrence Lee

Published in: Journal of Gastrointestinal Surgery | Issue 1/2020

Abstract

Introduction

Treatment delay may have detrimental effects on cancer outcomes. The impact of longer delays on colorectal cancer outcomes remains poorly described. The objective of this study was to determine the effect of delays to curative-intent surgical resection on survival in colorectal cancer patients.

Methods

All adult patients undergoing elective resection of primary non-metastatic colorectal adenocarcinoma from January 2009 to December 2014 were reviewed. Treatment delays were defined as the time from tissue diagnosis to definitive surgery, categorized as < 4, 4 to < 8, and ≥ 8 weeks. Primary outcomes were 5-year disease-free (DFS) and overall survival (OS). Statistical analysis included Kaplan–Meier curves and Cox regression models.

Results

A total of 408 patients were included (83.2% colon;15.8% rectal) with a mean follow-up of 58.4 months (SD29.9). Fourteen percent (14.0%) of patients underwent resection < 4 weeks, 40.0% 4 to < 8 weeks, and 46.1% ≥ 8 weeks. More rectal cancer patients had treatment delay ≥ 8 weeks compared with colonic tumors (69.8% vs. 41.4%, p < 0.001). Cumulative 5-year DFS and OS were similar between groups (p = 0.558; p = 0.572). After adjusting for confounders, surgical delays were not independently associated with DFS and OS.

Conclusions

Treatment delays > 4 weeks were not associated with worse oncologic outcomes. Delaying surgery to optimize patients can safely be considered without compromising survival.

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Title: The Impact of Delays to Definitive Surgical Care on Survival in Colorectal Cancer Patients
Authors: Maude Trepanier
Tiffany Paradis
Araz Kouyoumdjian
Teodora Dumitra
Patrick Charlebois
Barry S. Stein
A. Sender Liberman
Kevin Schwartzman
Franco Carli
Gerald M. Fried
Liane S. Feldman
Lawrence Lee
Publication date: 01-01-2020
Publisher: Springer US
Keywords: Rectal Cancer
Rectal Cancer
Colorectal Cancer
Colorectal Cancer
Published in: Journal of Gastrointestinal Surgery / Issue 1/2020
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04328-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Impact of Delays to Definitive Surgical Care on Survival in Colorectal Cancer Patients

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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