Adjuvant chemotherapy in patients with stage 3 colon cancer should be initiated within 8 weeks of surgery, a recent study published online ahead of print in the European Journal of Cancer has shown.1

Because current data suggest that delaying adjuvant chemotherapy in patients with colon cancer negatively impacts survival, researchers sought to identify which factors affect the timing of adjuvant chemotherapy and evaluate the effect on overall survival.

For the study, researchers analyzed data from 6,620 patients with stage 3 colon cancer who underwent resection and received adjuvant chemotherapy between 2008 and 2013 selected from the Netherlands Cancer Registry. Of those, 14% began chemotherapy after 8 weeks.

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Results showed that older age, emergency resection, anastomotic leakage, referral to another hospital for adjuvant chemotherapy, and prolonged postoperative hospital admission were factors associated with initiating treatment after 8 weeks post-surgery.

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Researchers found that starting chemotherapy 5 to 8 weeks post-surgery resulted in no decreased overall survival compared with starting within 4 weeks; however, initiating treatment after 8 weeks was associated with reduced overall survival compared with initiation within 8 weeks.

“Our data support initiating adjuvant chemotherapy in stage III colon cancer patients within 8 weeks post-surgery,” the authors concluded.


  1. Bos ACRK, van Erning FN, van Gestel YRBM, et al. Timing of adjuvant chemotherapy and its relation to survival among patients with stage III colon cancer [published online ahead of print September 7, 2015]. E J Cancer. doi: 10.1016/j.ejca.2015.08.016.