Journal article
How Soon Should Patients With Colon Cancer Undergo Definitive Resection?
Diseases of the colon & rectum, v 63(2)
01 Feb 2020
PMID: 31764246
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Timing of surgery has been shown to affect outcomes in many forms of cancer, but definitive national data do not exist to determine the effect of time to surgery on survival in colon cancer. OBJECTIVE: This study aimed to determine whether a delay in definitive surgery in colon cancer significantly affects survival. DATA SOURCES: A retrospective cohort study using 2 independent population-based databases, The Surveillance, Epidemiology, and End Results Medicare-linked database and the National Cancer Database, was performed. STUDY SELECTION: All patients had American Joint Committee on Cancer stage 1 through 3 colon cancer. Patients were more than 18 years of age in the National Cancer Database cohort and older than 66 years of age in the Medicare cohort. Patients had a minimum of 3 years of follow-up. MAIN OUTCOME MEASURES: The main outcome was overall survival as a function of time between diagnosis and surgery in 4 intervals (1-2, 3-4, 5-6, >6 weeks). RESULTS: The Medicare cohort demonstrated an adjusted 5-year survival of 8% to 14% higher in patients with a surgical delay between 3 and 6 weeks, with significantly lower hazard ratios in that interval. The National Cancer Database cohort demonstrated an adjusted 5-year survival of 9% to 16% higher in patients with surgery 3 to 6 weeks after diagnosis, with comparatively similar improvements in survival hazard. LIMITATIONS: Because this was a retrospective study of administrative databases, with Medicare data limited to billing data, the causality of outcomes must be interpreted with caution. CONCLUSIONS: The ideal timing of definitive resection in colon cancer is between 3 and 6 weeks after initial diagnosis. All efforts should be made for patients to obtain definitive surgery within this interval to achieve a modest but significant improvement in overall survival. See Video Abstract at . http://links.lww.com/DCR/B76.
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Details
- Title
- How Soon Should Patients With Colon Cancer Undergo Definitive Resection?
- Creators
- Robert J. Kucejko - Drexel UniversityTimothy J. Holleran - Drexel UniversityDavid E. Stein - Drexel UniversityJuan L. Poggio - Drexel University
- Publication Details
- Diseases of the colon & rectum, v 63(2)
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 11
- Grant note
- Drexel University Department of Surgery
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000509508700008
- Scopus ID
- 2-s2.0-85077761372
- Other Identifier
- 991019169546404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Gastroenterology & Hepatology
- Surgery