Time From Colorectal Cancer Surgery to Adjuvant Chemotherapy : Post Hoc Analysis of the SCOT Randomized Clinical Trial
| Title: | Time From Colorectal Cancer Surgery to Adjuvant Chemotherapy : Post Hoc Analysis of the SCOT Randomized Clinical Trial |
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| Authors: | Gögenur, Mikail; Weinberger Rosen, Andreas; Iveson, Timothy; Kerr, Rachel S.; Saunders, Mark P.; Cassidy, Jim; Tabernero, Josep; Haydon, Andrew; Glimelius, Bengt; Harkin, Andrea; Allan, Karen; Pearson, Sarah; Boyd, Kathleen A.; Briggs, Andrew H.; Waterston, Ashita; Medley, Louise; Ellis, Richard; Dhadda, Amandeep S.; Harrison, Mark; Falk, Stephen; Rees, Charlotte; Olesen, Rene K.; Propper, David; Bridgewater, John; Azzabi, Ashraf; Cunningham, David; Hickish, Tamas; Gollins, Simon; Wasan, Harpreet S.; Kelly, Caroline; Gogenur, Ismail; Holländer, Niels Henrik |
| Publisher Information: | Uppsala universitet, Cancerprecisionsmedicin Zealand Univ Hosp, Dept Surg, Surg Sci Ctr, Lykkebaekvej 1, DK-4600 Koge, Denmark. Zealand Univ Hosp, Dept Surg, Surg Sci Ctr, Lykkebaekvej 1, DK-4600 Koge, Denmark. Southampton Univ, Southampton, Hants, England. Univ Oxford, Dept Oncol, Oxford, England. Christie Hosp, Manchester, Lancs, England. Univ Glasgow, Sch Canc Sci, Glasgow Oncol Clin Trials Unit, Glasgow, Lanark, Scotland. Vall dHebron Univ Hosp, Barcelona, Spain.;Univ Autonoma Barcelona, Inst Oncol, Ctr Invest Biomed Red Canc, Barcelona, Spain. Australasian Gastrointestinal Trials Grp, Sydney, NSW, Australia. Univ Glasgow, Sch Canc Sci, Glasgow Oncol Clin Trials Unit, Glasgow, Lanark, Scotland. Univ Glasgow, Sch Canc Sci, Glasgow Oncol Clin Trials Unit, Glasgow, Lanark, Scotland. Univ Oxford, Dept Oncol, Oncol Clin Trials Off, Oxford, England. Univ Glasgow, Sch Hlth & Wellbeing, Glasgow, Lanark, Scotland. Univ Glasgow, Sch Hlth & Wellbeing, Glasgow, Lanark, Scotland.;London Sch Hyg & Trop Med, London, England. BeatsonWest Scotland Canc Ctr, Glasgow, Lanark, Scotland. Royal United Hosp, Bath, Avon, England. Royal Cornwall Hosp Natl Hlth Serv Trust, Truro, Cornwall, England. Castle Hill Hosp, Kingston Upon Hull, N Humberside, England. Mt Vernon Canc Ctr, Northwood, Middx, England. Bristol Canc Inst, Bristol, Avon, England. Southampton Univ, Southampton, Hants, England. Aalborg Univ Hosp, Dept Oncol, Aalborg, Denmark. Southampton Univ, Southampton, Hants, England.;Queen Mary Univ London, Barts Canc Inst, London, England. UCL, London, England. Newcastle Upon Tyne Hosp Natl Hlth Serv Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England. Brighton & Sussex Univ Hosp Trust, Brighton, E Sussex, England. Bournemouth Univ, Univ Hosp Dorset, Bournemouth, Dorset, England. North Wales Canc Treatment Ctr, Rhyl, Wales. Imperial Coll London, Hammersmith Hosp, London, England. Univ Glasgow, Sch Canc Sci, Glasgow Oncol Clin Trials Unit, Glasgow, Lanark, Scotland. Zealand Univ Hosp, Dept Surg, Surg Sci Ctr, Lykkebaekvej 1, DK-4600 Koge, Denmark.;Danish Colorectal Canc Grp, Copenhagen, Denmark.;Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark. Zealand Univ Hosp, Dept Clin Oncol & Palliat Care, Koge, Denmark. 2024 |
| Document Type: | Electronic Resource |
| Abstract: | Importance The timing of adjuvant chemotherapy after surgery for colorectal cancer and its association with long-term outcomes have been investigated in national cohort studies, with no consensus on the optimal time from surgery to adjuvant chemotherapy. Objective To analyze the association between the timing of adjuvant chemotherapy after surgery for colorectal cancer and disease-free survival. Design, Setting, and Participants This is a post hoc analysis of the phase 3 SCOT randomized clinical trial, from 244 centers in 6 countries, investigating the noninferiority of 3 vs 6 months of adjuvant chemotherapy. Patients with high-risk stage II or stage III nonmetastatic colorectal cancer who underwent curative-intended surgery were randomized to either 3 or 6 months of adjuvant chemotherapy consisting of fluoropyrimidine and oxaliplatin regimens. Those with complete information on the date of surgery, treatment type, and long-term follow-up were investigated for the primary and secondary end points. Data were analyzed from May 2022 to February 2024. Intervention In the post hoc analysis, patients were grouped according to the start of adjuvant chemotherapy being less than 6 weeks vs greater than 6 weeks after surgery. Main Outcomes and Measures The primary end point was disease-free survival. The secondary end points were adverse events in the total treatment period or the first cycle of adjuvant chemotherapy. Results A total of 5719 patients (2251 [39.4%] female; mean [SD] age, 63.4 [9.3] years) were included in the primary analysis after data curation; among them, 914 were in the early-start group and 4805 were in the late-start group. Median (IQR) follow-up was 72.0 (47.3-88.1) months, with a median (IQR) of 56 (41-66) days from surgery to chemotherapy. Five-year disease-free survival was 78.0% (95% CI, 75.3%-80.8%) in the early-start group and 73.2% (95% CI, 72.0%-74.5%) in the late-start group. In an adjusted Cox regression analysis, the start of adjuvant c |
| Index Terms: | Cancer and Oncology; Cancer och onkologi; Surgery; Kirurgi; Article in journal; info:eu-repo/semantics/article; text |
| DOI: | 10.1001.jamasurg.2024.1555 |
| URL: | http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-557457; JAMA Surgery, 2168-6254, 2024, 159:8, s. 865-871 |
| Availability: | Open access content. Open access content; info:eu-repo/semantics/restrictedAccess |
| Note: | English |
| Other Numbers: | UPE oai:DiVA.org:uu-557457; 0000-0001-9990-8155; 0000-0002-5440-791x; 0000-0002-0777-1997; 0000-0001-6770-7279; doi:10.1001/jamasurg.2024.1555; PMID 38865139; ISI:001247561400005; Scopus 2-s2.0-85196271107; 1541925588 |
| Contributing Source: | UPPSALA UNIV LIBR; From OAIster®, provided by the OCLC Cooperative. |
| Accession Number: | edsoai.on1541925588 |
| Database: | OAIster |