Patients with stage III colorectal cancer who experience surgical complications are at increased risk for omission of chemotherapy and for delay in adjuvant chemotherapy, according to a new study in the December issue of Diseases of the Colon & Rectum.
Using the Surveillance, Epidemiology and End Results-Medicare database, researchers compared stage III colorectal patients with surgical complications with those without surgical complications. In the study group (n = 17,108; median age, 75 years; 24% rectal/rectosigmoid) 18% of patients had at least one complication. Of these, 13% had medical complications and 3.8% had complications that required reoperation or another procedure.
The researchers found that 46% of patients with complications did not receive adjuvant chemotherapy compared with 31% of those without complications. Upon univariate analysis and multiple logistic regression, they associated experiencing one surgical complication with omission of chemotherapy (adjusted overall risk, 1.76; 95% confidence interval, 1.59-1.95) and found that the risk increased with multiple complications (P <.0001). In addition, surgical complications were associated with delay in adjuvant chemotherapy (P <.0001).
The researchers noted that, based on these data, surgical complications may be affecting both the short- and long-term outcomes for patients with stage III colon cancer.