000			03480nam a22004937a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a0003-1348
040			_aOvid MEDLINE(R)
099			_a38655912
245			_aPredictors of Timely Initiation and Completion of Adjuvant Chemotherapy in Stage II/III Colorectal Adenocarcinoma.
251			_aAmerican Surgeon. :31348241248689, 2024 Apr 24
252			_aAm Surg. :31348241248689, 2024 Apr 24
253			_aThe American surgeon
260			_c2024
260			_p2024 Apr 24
265			_saheadofprint
265			_tPublisher
266			_d2024-07-23
501			_aAvailable online through MWHC library: 2005 - present, Available in print through MWHC library:1999-2007
520			_aBackground: Adjuvant chemotherapy (AC) for colorectal cancer (CRC) has led to substantial improvement in survival. Several clinical trials advocate the initiation of AC within 6-8 weeks of surgical resection based on evidence of improved survival with early initiation of AC. We aim to evaluate factors that predict initiation and completion of AC, subsequently improving survival. Methods: We identified 451 patients who underwent resection for CRC between 2014 and 2022. One hundred ten patients had stage II/III colorectal cancer who underwent resection followed by AC. Multivariable logistic regression analysis was performed to identify factors significantly predicting delay in AC >8 weeks. Secondary outcomes included chemotherapy completion rate, recurrence-free survival, and overall survival. Results: The final analysis included 110 patients. The median time to initiation of adjuvant chemotherapy (TIAC) was 6.9 weeks (IQR: 5.8-9.5). In total, 36.4% of patients had a delay >8 weeks to initiation of AC, and only 40% completed treatment. The surgical approach (open vs laparoscopic vs robotic) had no effect on the TIAC. On multivariable logistic regression analysis, preoperative albumin >=3.5 (OR = .31; 95% CI: .12-.80) was an independent predictor of timely initiation of AC. Completion of AC was associated with a higher overall survival. Discussion: Preoperative nutritional status predicted delay in initiation of AC. Patients with a delay in AC beyond eight weeks had a lower rate of AC completions and worse survival. It is imperative to optimize this aspect of treatment as it correlates with survival.
546			_aEnglish
650			_zAutomated
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Franklin Square Medical Center
656			_aGeneral Surgery Residency
656			_aSurgery
657			_aJournal Article
700			_aAlmanzar, Anyelin _bMFSMC
700			_aAlnajjar, Said _bMFSMC _cGeneral Surgery Residency _dMD
700			_aGupta, Vinay _bMSFMC
700			_aLisle, David _bMFSMC
700			_aShoucair, Sami _bMFSMC
700			_aZheng, Kan _bMFSMC
790			_aAlnajjar S, Shoucair S, Almanzar A, Zheng K, Lisle D, Gupta V
856			_uhttps://dx.doi.org/10.1177/00031348241248689 _zhttps://dx.doi.org/10.1177/00031348241248689
858			_yAlmanzar, Anyelin; RINGGOLD: 23435 _zhttps://orcid.org/0009-0002-1747-2410
858			_yAlnajjar, Said _uhttps://orcid.org/0009-0002-1747-2410
858			_yAlnajjar, Said; RINGGOLD: 23435
858			_yGupta, Vinay; RINGGOLD: 23435
858			_yLisle, David; RINGGOLD: 23435
858			_yShoucair, Sami; RINGGOLD: 23435
858			_yZheng, Kan; RINGGOLD: 23435
942			_cART _dArticle
999			_c14163 _d14163