Does Delaying Curative Surgery for Colorectal Cancer Influence Long-term Disease Free Survival.

Fundación para la Investigación del Hospital Clínico de Valencia

Status: Completed

Conditions: Colorectal Cancer

Treatments: Other: Wait list time

Study type: Observational

Funder types: Other

Identifiers

NCT04430231

2019/285

Details and patient eligibility

About

This work is an original clinical research article describing the relationship between wait list tome for colorectal cancer patients and long-term survival. These findings are particularly relevant for management of surgical wait lists during crisis such as the Covid-19 pandemic. The lack of a relationship between wait list time and disease free survival and tendency for improved survival in the 4-6 week imply some colorectal cancer operations can be safely delayed during times of limited resources.

Full description

Background Surgical wait list time is a major problem in many health-care systems and its influence on survival is unclear. The aim of this study is to assess the impact of the wait list time on long term disease-free survival in patients scheduled for colorectal cancer resection.

Materials and Methods A prospective, single center study was carried out in patients with stage I-III colorectal cancer scheduled for surgery between 2012-2017 at a Colorectal Surgery Unit of a tertiary care center. Wait list time was defined as the time from completion of diagnostic workup and definitive surgery and divided into 2-week intervals from 2 to 6 weeks. The outcome variables were 2- and 5-year disease free survival. Screening for disease progression was with carcinoembryonic antigen levels and chest/abdominal computed tomography scan. Data was collected prospectively and subsequently analyzed.

Enrollment: 602 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Joint Committee on Cancer (AJCC) stage I through III confirmed adenocarcinomas
• With "colon" or "upper rectum" as their primary site of malignancy according to International Classification of Diseases for Oncology, Third Edition topography code.

Exclusion criteria

• Emergency surgery,
• More than one primary site,
• Synchronous metastasis or peritoneal carcinomatosis at the time of surgery
• If they received neoadjuvant chemoradiotherapy
• If they had a local transanal excision.

Trial design

602 participants in 4 patient groups

Wait list time 0-2 weeks

Description:

Wait list time 0-2 weeks

Treatment:

Other: Wait list time

Wait list time 2-4 weeks

Description:

Wait list time 2-4 weeks

Treatment:

Other: Wait list time

Wait list time 4-6 weeks

Description:

Wait list time 4-6 weeks

Treatment:

Other: Wait list time

Wait list time > 6 weeks

Description:

Wait list time \> 6 weeks

Treatment:

Other: Wait list time