Safety and feasibility of in-hospital early chemotherapy initiation after surgery in patients with stage II-IV colon cancer

Abstract

Although it is recommended to initiate postoperative chemotherapy for colon cancer within 8 weeks after surgery, the feasibility and impact of initiating chemotherapy before discharge after surgical resection has not been investigated.Patients with stage II-IV colon cancer who received postoperative chemotherapy were dichotomized into early (chemotherapy initiation before discharge) and control (chemotherapy initiation after discharge) groups. A multivariable logistic regression model was used to determine factors associated with delayed chemotherapy, defined as more than 6 or 8 weeks after surgery.From January 2004 to December 2012, of 729 patients with stage II-IV colon adenocarcinoma, 555 patients (76.1%) underwent postoperative chemotherapy. Of them, 181 (32.6%) patients were included in the early group. Time to initiation of chemotherapy was significantly shorter in the early group than in the control group (14.9 days vs 31.5 days, P < . 001). Multivariate analysis revealed that tumor stage and chemotherapy initiation strategy (odds ratio 8.4; 95% confidence interval, 1-66, P = .041) were independent predictors of delayed initiation of chemotherapy at more than 8 weeks. There was no difference in the completion rate of planned chemotherapy cycles between the 2 groups (P > .05).The strategy of initiating chemotherapy before discharge after surgery is safe and feasible and might reduce the potential delay in chemotherapy initiation in patients with colon cancer.