Surgical Complications Linked to Delayed Chemo in CRC Patients

HealthLeaders Media Staff, December 22, 2010

Patients who have complications after colorectal cancer surgery are less likely to get chemotherapy, even when it is clearly recommended for their diagnosis, a study in the December issue of the journal Diseases of the Colon & Rectum.

In addition, patients with complications were more than twice as likely to have their chemotherapy delayed for more than 120 days after diagnosis or two months after surgery (the appropriate timeframe for receiving chemotherapy).

Surgical complications are independently associated with omission of chemotherapy for stage III colorectal cancer and with a delay in adjuvant chemotherapy; this suggests that complications of colorectal surgery may affect both short- and long-term cancer outcomes, researchers found.

"Surgical complications are typically thought to be short-term problems, but our study suggests there is a clear link between downstream cancer care and complications that occur during surgery. This is critical because chemotherapy in this subset of colorectal cancer patients has clear lifesaving benefit," according to lead study author Samantha Hendren, M.D., M.P.H., FACS, assistant professor of surgery, University of Michigan Health System.

The study looked at data from 17,108 patients who had surgery for stage III colorectal cancer. Chemotherapy is recommended for all stage III colorectal cancer patients and has been shown to improve survival as much as 16 percent after five years. Patients were identified for the study from the Surveillance, Epidemiology and End Results-Medicare database, a large population-based registry.

Because chemotherapy stresses the body and slows healing, medical oncologists are generally reluctant to give chemotherapy to patients who are frail or unwell because of complications from surgery. Hendren also suggests that some patients may opt out of chemotherapy after experiencing surgical complications.

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