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Optimal Time of Initiating Adjuvant Chemotherapy After Curative Surgery in Colorectal Cancer Patients

대한대장항문학회지 2013년 29권 4호 p.150 ~ 154
 ( Kang Kyu-Min ) - Ewha Womans University School of Medicine Department of Surgery

 ( Hong Kyung-Sook ) - Ewha Womans University School of Medicine Department of Surgery
 ( Noh Gyoung-Tae ) - Ewha Womans University School of Medicine Department of Surgery
 ( Oh Bo-Young ) - Ewha Womans University School of Medicine Department of Surgery
 ( Chung Soon-Sup ) - Ewha Womans University School of Medicine Department of Surgery
 ( Lee Ryung-Ah ) - Ewha Womans University School of Medicine Department of Surgery
 ( Kim Kwang-Ho ) - Ewha Womans University School of Medicine Department of Surgery

Abstract


Purpose: Adjuvant chemotherapy is routinely recommended for locally advanced colorectal cancer (CRC). There are very few data for the optimal starting date of adjuvant chemotherapy after the surgery. This study aimed to evaluate the effectiveness of earlier adoption of adjuvant chemotherapy after curative surgery for stage III CRC. Methods: In this study, 159 patients with stage III CRC, who had undergone a curative resection, were enrolled retrospectively. Patients were categorized into 3 groups representing different timings to initiate the chemotherapy; less than 2 weeks (group 1), 3 to 4 weeks (group 2), and more than 5 weeks (group 3). The overall survival rate (OS) and the relapse-free survival rate (RFS) were analyzed to evaluate the effectiveness of adjuvant chemotherapy. Results: The 5-year OSs of the patients were 73.7% in group 1, 67.0% in group 2, and 55.2% in group 3. The 5-year RFSs of the patients were 48.8% in group 1, 64.7% in group 2, and 57.1% in group 3. There were no significant differences in either the OS or the RFS (P = 0.200, P = 0.405). Conclusion: Starting chemotherapy earlier than 6 weeks after surgery does not show any significant difference. Thus, although adjuvant chemotherapy should preferably begin within 6 weeks, the starting date should not necessarily be hastened, and the patient’s general condition should be taken into consideration.

키워드

Adjuvant chemotherapy; Colorectal neoplasms; Prognosis; Therapeutic guidelines
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