Return to intended oncologic therapy after colectomy for stage III colon adenocarcinoma: Does surgical approach matter?

被引:3
作者
Pointer Jr, David T. T. [1 ]
Felder, Seth I. I. [2 ]
Powers, Benjamin D. D. [2 ]
Dessureault, Sophie [2 ]
Sanchez, Julian A. A. [2 ]
Imanirad, Iman [2 ]
Sahin, Ibrahim [2 ]
Xie, Hao [2 ]
Naffouje, Samer A. A. [2 ]
机构
[1] Tulane Univ, Dept Surg, Sch Med, 1430 Tulane Ave 8622, New Orleans, LA 70112 USA
[2] H Lee Moffitt Canc Ctr & Res Inst, Dept Gastrointestinal Oncol, Tampa, FL USA
关键词
adjuvant therapy; colon cancer; minimally invasive colectomy; RIOT; robotic colectomy; ADJUVANT CHEMOTHERAPY; LAPAROSCOPIC COLECTOMY; COLORECTAL-CANCER; CLASICC TRIAL; INITIATION; SURGERY; RESECTION; SURVIVAL; FLUOROURACIL; ASSOCIATION;
D O I
10.1111/codi.16661
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim: Return to intended oncologic treatment (RIOT) is an important paradigm for surgically resected cancers requiring multimodal treatment. Benefits of minimally invasive colectomy (MIC) may allow earlier initiation of adjuvant chemotherapy (ACT) and have associated survival benefits. We sought to determine if operative approach affects RIOT timing in resected stage III colon cancer.Methods: NCDB identified pathological stage III colon adenocarcinoma patients who underwent resection and received ACT. Propensity score matching and kernel density estimation compared operative approaches and conversion impact on intervals to RIOT.Results: A total of 15,132 open colectomies (OC) versus 14,107 MIC were included. MIC patients had two-days shorter median length of stay (LOS) (4 vs. 6 days; p < 0.001), one-week shorter median time to RIOT (6 vs. 7 weeks; p = 0.015) comparing 12,867 matched pairs. There was no difference in time interval to RIOT between the LC versus RC, converted MIC vs. OC groups. MIC was a favourable predictor of earlier RIOT (HR 1.14 [1.07-1.22]; p < 0.001).Conclusion: MIC in stage III colon cancer is associated with a shorter time to RIOT when compared to OC. Since timely initiation of ACT may influence cancer outcome, MIC may be oncologically preferable. Prospective studies are needed to assess RIOT and survival outcomes in stage III colon cancer.
引用
收藏
页码:1760 / 1770
页数:11
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