- Starting adjuvant chemotherapy (ACT) within 6-8 weeks of surgery was associated with improved survival in colorectal and gastric cancer, but not pancreatic cancer.
Why this matters
- There is a lack of prospective clinical trials examining whether delays past 6-8 weeks can affect results in these cancers.
- Systematic review and meta-analysis of 3 post hoc analyses of randomized controlled trials, 1 prospective study, and numerous retrospective studies (34 studies; n=141,853).
- Funding: No external funding.
- For colorectal cancer, there was increased risk for mortality with a delay (combined HR for delayed vs earlier ACT, 1.27; P<.001 with moderately high heterogeneity>2=70%; P<.001>
- An analysis that sequentially removed the 4 studies with the highest weight yielded statistically significant HRs ranging from 1.25 to 1.28.
- Most included studies were retrospective.