The impact of adjuvant chemotherapy timing on overall survival following XXXX resection.

@entity5 @entity1 @entity694 @entity14
BACKGROUND: Several studies including two meta-analyses have showed that delay between surgery and adjuvant chemotherapy adversely impacts @entity14 survival. This study investigated this impact at a population level over a fifteen year period in England. METHODS: The Hospital Episode Statistics database was analysed between 1997 and 2012. @entity694 and @entity5 @entity1 were collated and multivariate Cox regression analyses were undertaken to ascertain the relationship between chemotherapy delay and overall survival. RESULTS: A total of 181  984 @entity1 underwent resection without any reoperation (106  477 (58.5%) having @entity694 and 75  507 (41.5%) having @entity5 ). In total, 30  836 (16.9%) received adjuvant chemotherapy. 9019 (49.3%), 4573 (25.0%), 2587 (14.1%), 1323 (7.2%) and 804 (4.4%) of 18  306 @entity694 @entity1 received within 8 weeks, 8-10 weeks, 10-12 weeks, 12-14 weeks and 14-16 weeks, respectively. Sequentially worse overall survival was observed: <8 weeks: Ref; 8-10  wks: Hazard Ratio (HR) 1.09; 10-12  wks: HR 1.13; 12-14  wks HR 1.32 and 14-16  wks: HR 1.32, p  <  0.001. 5625 (44.9%), 3087 (24.6%), 1940 (15.5%), 1162 (9.3%) and 716 (5.7%) of 12  530 @entity5 @entity1 received within 8 weeks, 8-10 weeks, 10-12 weeks, 12-14 weeks and 14-16 weeks, respectively. Sequentially worse overall survival was observed: <8 weeks: Ref; 8-10  wks: HR 1.09; 10-12  wks: HR 1.22; 12-14  wks HR 1.23 and 14-16  wks: HR 1.31, p  <  0.001. CONCLUSION: Adjuvant chemotherapy delay adversely impacts colonic and @entity5 survival. Efforts to prevent complications such as reoperation and to improve access to chemotherapy services, will improve survival in this @entity1 cohort.
