Treatment interval in curative treatment of colon cancer, does it impact (cancer free) survival? A non-inferiority analysis.

Autor: Strous MTA; Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands. m.strous@maastrichtuniversity.nl.; Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. m.strous@maastrichtuniversity.nl., Molenaar CJL; Department of Surgery, Maxima Medical Centre, Veldhoven, The Netherlands., Franssen RFW; Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands., van Osch F; Department of Epidemiology, VieCuri Medical Centre, Venlo, the Netherlands., Belgers E; Department of Surgery, Zuyderland Hospital, Heerlen, The Netherlands., Bloemen JG; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., Slooter GD; Department of Surgery, Maxima Medical Centre, Veldhoven, The Netherlands., Melenhorst J; Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.; Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands., Heemskerk J; Department of Surgery, Laurentius Hospital, Roermond, The Netherlands., de Bruïne AP; Department of Pathology, VieCuri Medical Centre, Venlo, The Netherlands., Janssen-Heijnen MLG; Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.; Department of Epidemiology, VieCuri Medical Centre, Venlo, the Netherlands., Vogelaar FJ; Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands.; Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2024 Feb; Vol. 130 (2), pp. 251-259. Date of Electronic Publication: 2023 Dec 12.
DOI: 10.1038/s41416-023-02505-6
Abstrakt: Background: In treatment of colon cancer, strict waiting-time targets are enforced, leaving professionals no room to lengthen treatment intervals when advisable, for instance to optimise a patient's health status by means of prehabilitation. Good quality studies supporting these targets are lacking. With this study we aim to establish whether a prolonged treatment interval is associated with a clinically relevant deterioration in overall and cancer free survival.
Methods: This retrospective multicenter non-inferiority study includes all consecutive patients who underwent elective oncological resection of a biopsy-proven primary non-metastatic colon carcinoma between 2010 and 2016 in six hospitals in the Southern Netherlands. Treatment interval was defined as time between diagnosis and surgical treatment. Cut-off points for treatment interval were ≤35 days and ≤49 days.
Findings: 3376 patients were included. Cancer recurred in 505 patients (15.0%) For cancer free survival, a treatment interval >35 days and >49 days was non-inferior to a treatment interval ≤35 days. Results for overall survival were inconclusive, but no association was found.
Conclusion: For cancer free survival, a prolonged treatment interval, even over 49 days, is non-inferior to the currently set waiting-time target of ≤35 days. Therefore, the waiting-time targets set as fundamental objective in current treatment guidelines should become directional instead of strict targets.
(© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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