Annals of Surgical Oncology

, Volume 21, Issue 11, pp 3587–3591 | Cite as

Laparoscopic Colectomy Decreases the Time to Administration of Chemotherapy Compared with Open Colectomy

  • Vitaliy Poylin
  • Thomas Curran
  • Eliza Lee
  • Deborah Nagle
Colorectal Cancer

Abstract

Background

Minimally invasive colon surgery (MIS) has been shown to minimize pain and decrease overall recovery time. No studies have shown a clear oncologic benefit. Some literature suggests that the time to administration of chemotherapy can be important to improve outcomes for advanced colon cancer. The goal of this study is to evaluate the effect of minimally invasive surgery on the timing of chemotherapy administration.

Methods

This was a retrospective review of all patients undergoing surgery for colon cancer at a tertiary institution between 2004 and 2013.

Results

A total of 668 partial colectomies for cancer were performed; 241 were stage III and above and deemed appropriate for chemotherapy. Eighty-five patients did not receive chemotherapy (patient’s wishes, age/comorbidities or lost to follow-up). Of the 156 patients who received chemotherapy, 57 underwent MIS and 99 had open colectomy. Average time to chemotherapy after MIS colectomy was 42.9 versus 60.3 days for open surgery (p < 0.001). In the open group, 52 (53 %) people had postoperative complications and readmissions versus 24 (39 %) in the MIS group. Postoperative complications increased the time to chemotherapy for all patients. However, among patients with complications, patients in the MIS group were still able to start chemotherapy earlier (p < 0.05) than open colectomy patients. Multivariate analysis revealed the MIS approach as the only factor lowering time between surgery and chemotherapy.

Conclusions

Laparoscopic colectomy decreases the time interval from surgery to the start of chemotherapy compared with open colectomy. Postoperative complications increase the time to chemotherapy for both open and MIS surgery.

Notes

Disclosures

Vitaliy Poylin, Thomas Curran, Eliza Lee, and Deborah Nagle have no disclosures to declare.

References

  1. 1.
    Sargent DJ, Goldberg RM, Jacobson SD, et al. A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med. 2001;345(15):1091–97.PubMedCrossRefGoogle Scholar
  2. 2.
    Biagi JJ, Raphael MJ, Mackillop WJ, Kong W, King WD, Booth CM. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: a systematic review and meta-analysis. JAMA. 2011;305(22):2335–42.PubMedCrossRefGoogle Scholar
  3. 3.
    Benson AB 3rd, Schrag D, Somerfield MR, et al. American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol. 2004;22:3408–19.PubMedCrossRefGoogle Scholar
  4. 4.
    Jee SH, Moon SM, Shin US, Yang HM, Hwang DY. Effectiveness of 5-FU/leucovorin and prognosis in stage II colon cancer. J Korean Soc Coloproctol. 2011;27(6):322–8.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Hershman D, Hall MJ, Wang X, Jacobson JS, McBride R, Grann VR, et al. Timing of adjuvant chemotherapy initiation after surgery for stage III colon cancer. Cancer. 2006;107:2581–88.PubMedCrossRefGoogle Scholar
  6. 6.
    Bayraktar UD, Chen E, Bayraktar S, Sands LR, Marchetti F, Montero AJ, et al. Does delay of adjuvant chemotherapy impact survival in patients with resected stage II and III colon adenocarcinoma? Cancer. 2010;117;2364–70.PubMedCrossRefGoogle Scholar
  7. 7.
    André T, Quinaux E, Louvet C, et al. Phase III study comparing a semimonthly with a monthly regimen of fluorouracil and leucovorin as adjuvant treatment for stage II and III colon cancer patients: final results of GERCOR C96.1. J Clin Oncol. 2007;25:3732–38.PubMedCrossRefGoogle Scholar
  8. 8.
    Taal BG, Van Tinteren H, Zoetmulder FA; NACCP group. Adjuvant 5FU plus levamisole in colonic or rectal cancer: improved survival in stage II and III. Br J Cancer. 2001;85:1437–43.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Czaykowski PM, Gill S, Kennecke HF, Gordon VL, Turener D. Adjuvant chemotherapy for stage III colon cancer: does timing matter? Dis Colon Rectum. 2011;54(9):1082–89.PubMedCrossRefGoogle Scholar
  10. 10.
    Zeig-Owens R, Gershman ST, Knowlton R, Jacobson JS. Survival and time interval from surgery to start of chemotherapy among colon cancer patients. J Regist Manag. 2009;36(2):30–41.Google Scholar
  11. 11.
    Schwenk W, Haase O, Neudecker J, Muller JM. Short benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev. 2005;(3):CD003145.Google Scholar
  12. 12.
    Matsuzaki S, Bourdel N, Darcha C, et al. Molecular mechanisms underlying postoperative peritoneal tumor dissemination may differ between a laparotomy and carbon dioxide pneumoperitoneum: a syngeneic mouse model with controlled respiratory support. Surg Endosc. 2009;23(4):705–14.PubMedCrossRefGoogle Scholar
  13. 13.
    O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY. Rates of colon and rectal cancers are increasing in young adults. Am Surg. 2003;69(10):866–72.PubMedGoogle Scholar
  14. 14.
    Des Guetz G, Nicholas P, Perret GY, Morere JF, Uzzan B. Does delaying chemotherapy after curative surgery for colorectal cancer impair survival: a meta-analysis. Eur J Cancer. 2010;46:1049–55.PubMedCrossRefGoogle Scholar
  15. 15.
    Hazebroek EJ; Color Study Group. COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer. Surg Endosc. 2002;16:949–53.PubMedCrossRefGoogle Scholar
  16. 16.
    Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–84.PubMedCrossRefGoogle Scholar
  17. 17.
    Jayne DG, Guillou PJ, Thorpe H, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol. 2007;25(21):3061–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Lacy AM, Garcia-Valdecasa JC, Delgado S, Castells A, Taura P, Pique JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet. 2002;359(9325):2224–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Strouch MJ, Zhou G, Fleshman JW, Birnbaum EH, Hunt SR, Mutch MG. Time to initiation of postoperative chemotherapy: an outcome measure for patients undergoing laparoscopic resection for rectal cancer. Dis Colon Rectum. 2013;56(8):945–51.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Vitaliy Poylin
    • 1
  • Thomas Curran
    • 1
  • Eliza Lee
    • 1
  • Deborah Nagle
    • 1
  1. 1.Colon & Rectal SurgeryBeth Israel Deaconess Medical CenterBostonUSA

Personalised recommendations