Time to adjuvant chemotherapy following colorectal cancer resection is associated with an improved survival

A R Day, G Middleton, R V P Smith, I C Jourdan, T A Rockall

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


AIM: Multicentre randomized trials have demonstrated equivalent long-term outcomes for open and laparoscopic resection of colon cancer. Some studies have indicated a possible survival advantage in certain patients undergoing laparoscopic resection. Patients who receive adjuvant chemotherapy in < 8 weeks following surgery can have an improved survival.

METHOD: Data were collated for patients having an elective laparoscopic or open resection for non-metastatic colorectal cancer between October 2003 and December 2010 and subsequently having adjuvant chemotherapy. Survival analysis was conducted.

RESULTS: In all, 209 patients received adjuvant chemotherapy following open (n = 76) or laparoscopic (n = 133) surgery. Median length of stay was 3 days with laparoscopic resection and 6 days with open resection (P < 0.0005). Median number of days to initiation of adjuvant chemotherapy was 52 with laparoscopic resection and 58 with open resection (P = 0.008). The 5-year overall survival was 89.6% in patients receiving chemotherapy in < 8 weeks after surgery, compared with 73.5% who started the treatment over 8 weeks (P = 0.016). The 5-year overall survival for those patients with a laparoscopic resection was 82.3% compared with 80.3% with an open resection (P = 0.049).

CONCLUSION: There is an overall survival advantage when patients receive adjuvant chemotherapy < 8 weeks after surgery. Laparoscopic resection allows earlier discharge and, subsequently, earlier initiation of adjuvant chemotherapy.

Original languageEnglish
Pages (from-to)368-72
Number of pages5
JournalColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
Issue number5
Publication statusPublished - May 2014

Bibliographical note

Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.


  • Aged
  • Antineoplastic Agents
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Period
  • Retrospective Studies
  • Survival Rate
  • Time Factors


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