Impact of Adjuvant Chemotherapy Delay on Outcome in Cancer Colon Patients

Background: When adjuvant chemotherapy is indicated in colorectal carcinoma (CRC) it is usually prescribed within two months after curative surgery. The effect of delay in adjuvant chemotherapy is unclear. The aim of this retrospective study was to assess the impact of adjuvant CT delay beyond 8 weeks (56 days) in stage III and high risk stage II colon cancer patients on DFS and OS.Patients and Methods: This retrospective study was conducted through revision of medical records of patients diagnosed with stage II-III colon adenocarcinoma who received adjuvant CT after complete surgical resection at the department of Clinical Oncology, Ain Shams University Hospitals.Results: Between January 2003 and August 2008, 108 patients were included. Patients were divided into 2 groups: Group I including 62 patients who started adjuvant CT 56 days from surgery and group II which included 46 patients who had CT delay ³56 days. Both groups were matched demographically. Disease free survival was found to be significantly worse in group II patients compared to group I patients. Median DFS was 18±9.3 and 27±14.13 in the two groups respectively (p=.000). There was no significant difference in OS between the two groups. Analysis of other prognostic factors (age, sex, T, N, CT type) were done with only nodal status predicted for worse DFS (p=0.05) and OS (p= 0.006).Conclusion: Delay in starting adjuvant chemotherapy for high risk stage II, and stage III colorectal cancer patients was associated with lower DFS but no difference in OS.