Time from colorectal cancer diagnosis to laparoscopic curative surgery—is there a safe window for prehabilitation?
Background There is a growing interest in the adoption of formal prehabilitation programmes prior to elective surgery but regulatory targets mandate prompt treatment following cancer diagnosis. We aimed to investigate if time from diagnosis to surgery is linked to short- and long-term outcomes. Meth...
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| Veröffentlicht in: | International journal of colorectal disease 2018-07, Vol.33 (7), p.979-983 |
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| container_title | International journal of colorectal disease |
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| creator | Curtis, N. J. West, M. A. Salib, E. Ockrim, J. Allison, A. S. Dalton, R. Francis, Nader K. |
| description | Background
There is a growing interest in the adoption of formal prehabilitation programmes prior to elective surgery but regulatory targets mandate prompt treatment following cancer diagnosis. We aimed to investigate if time from diagnosis to surgery is linked to short- and long-term outcomes.
Methods
An exploratory analysis was performed utilising a dedicated, prospectively populated database. Inclusion criteria were biopsy-proven colorectal adenocarcinoma undergoing elective laparoscopic surgery with curative intent. Demographics, date of diagnosis and surgery was captured with patients dichotomised using 4-, 8- and 12-week time points. All patients were followed in a standardised pathway for 5 years. Overall survival was assessed with the Kaplan-Meier log-rank method.
Results
Six hundred sixty-eight consecutive patients met inclusion criteria. Mean time from diagnosis to surgery was 53 days (95% CI 48.3–57.8). Identified risk factors for longer time to surgery were males (OR 1.92 [1.2–3.1],
p
= 0.008), age ≤ 65 (OR 1.9 [1.2–3],
p
= 0.01), higher ASA scores (
p
= 0.01) stoma formation (OR 6.9 [4.1–11],
p
|
| doi_str_mv | 10.1007/s00384-018-3016-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2018663007</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714488433</galeid><sourcerecordid>A714488433</sourcerecordid><originalsourceid>FETCH-LOGICAL-c439t-67bd77454fc6baade9edc59e25e24bcd5932220ba5c16ce6b2065bd03c3dc7843</originalsourceid><addsrcrecordid>eNp1kc1u1TAQhS0EopfCA7BBltiwSfF_khWqKlqQKrEpa8sZT25dJXGwE6rueAiekCfB0S1UIJAXlu3vzBzPIeQlZyecsfptZkw2qmK8qSTjpmoekR1XUlRcGPGY7Biv24q3ujkiz3K-YeVsavWUHIlW10ozsyPLVRiR9imOFOIQE8LiBgpuAkzUB7efYg6ZLpEObnYpZohzAAprckv4ijSvaY_p7se37xt1jQmpo9n1SG_D5OMt7WOic8Jr14UhLEUUp3fPyZPeDRlf3O_H5PP5-6uzD9Xlp4uPZ6eXFSjZLpWpO18Xn6oH0znnsUUPukWhUagOvG6lEIJ1TgM3gKYTzOjOMwnSQ90oeUzeHOrOKX5ZMS92DBlwGNyEcc1WlMkZI8soC_r6L_Qmrmkq7jaq1kpryR6ovRvQhqmPS3KwFbWnNVeqKU1loU7-QZXlcQwQJ-xDuf9DwA8CKAPOCXs7pzC6dGc5s1vS9pC0LX7tlrRtiubVveG1G9H_VvyKtgDiAOTyNJWQHn70_6o_AXi0tKE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2017545530</pqid></control><display><type>article</type><title>Time from colorectal cancer diagnosis to laparoscopic curative surgery—is there a safe window for prehabilitation?</title><source>SpringerLink Journals - AutoHoldings</source><creator>Curtis, N. J. ; West, M. A. ; Salib, E. ; Ockrim, J. ; Allison, A. S. ; Dalton, R. ; Francis, Nader K.</creator><creatorcontrib>Curtis, N. J. ; West, M. A. ; Salib, E. ; Ockrim, J. ; Allison, A. S. ; Dalton, R. ; Francis, Nader K.</creatorcontrib><description>Background
There is a growing interest in the adoption of formal prehabilitation programmes prior to elective surgery but regulatory targets mandate prompt treatment following cancer diagnosis. We aimed to investigate if time from diagnosis to surgery is linked to short- and long-term outcomes.
Methods
An exploratory analysis was performed utilising a dedicated, prospectively populated database. Inclusion criteria were biopsy-proven colorectal adenocarcinoma undergoing elective laparoscopic surgery with curative intent. Demographics, date of diagnosis and surgery was captured with patients dichotomised using 4-, 8- and 12-week time points. All patients were followed in a standardised pathway for 5 years. Overall survival was assessed with the Kaplan-Meier log-rank method.
Results
Six hundred sixty-eight consecutive patients met inclusion criteria. Mean time from diagnosis to surgery was 53 days (95% CI 48.3–57.8). Identified risk factors for longer time to surgery were males (OR 1.92 [1.2–3.1],
p
= 0.008), age ≤ 65 (OR 1.9 [1.2–3],
p
= 0.01), higher ASA scores (
p
= 0.01) stoma formation (OR 6.9 [4.1–11],
p
< 0.001) and neoadjuvant treatment (OR 5.06 [3.1–8.3],
p
< 0.001). There was no association between time to surgery and BMI (
p
= 0.36), conversion (16.3%,
p
= 0.5), length of stay (
p
= 0.33) and readmission or reoperation (
p
= 0.3). No differences in five-year survival were seen in those operated within 4, 8 and 12 weeks (
p
= 0.397,
p
= 0.962 and
p
= 0.611, respectively). Multivariate analysis showed time from diagnosis to surgery was not associated with five-year overall survival (HR 0.99,
p
= 0.52).
Conclusion
Time from colorectal cancer diagnosis to curative laparoscopic surgery did not impact on overall survival. This finding may allow preoperative pathway alteration without compromising safety.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-018-3016-8</identifier><identifier>PMID: 29574506</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adenocarcinoma ; Analysis ; Biopsy ; Cancer ; Care and treatment ; Colorectal cancer ; Colorectal carcinoma ; Demography ; Diagnosis ; Gastroenterology ; Hepatology ; Internal Medicine ; Laparoscopic surgery ; Laparoscopy ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Patients ; Proctology ; Risk factors ; Short Communication ; Surgery ; Survival</subject><ispartof>International journal of colorectal disease, 2018-07, Vol.33 (7), p.979-983</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>International Journal of Colorectal Disease is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-67bd77454fc6baade9edc59e25e24bcd5932220ba5c16ce6b2065bd03c3dc7843</citedby><cites>FETCH-LOGICAL-c439t-67bd77454fc6baade9edc59e25e24bcd5932220ba5c16ce6b2065bd03c3dc7843</cites><orcidid>0000-0001-5655-6823</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-018-3016-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-018-3016-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29574506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Curtis, N. J.</creatorcontrib><creatorcontrib>West, M. A.</creatorcontrib><creatorcontrib>Salib, E.</creatorcontrib><creatorcontrib>Ockrim, J.</creatorcontrib><creatorcontrib>Allison, A. S.</creatorcontrib><creatorcontrib>Dalton, R.</creatorcontrib><creatorcontrib>Francis, Nader K.</creatorcontrib><title>Time from colorectal cancer diagnosis to laparoscopic curative surgery—is there a safe window for prehabilitation?</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Background
There is a growing interest in the adoption of formal prehabilitation programmes prior to elective surgery but regulatory targets mandate prompt treatment following cancer diagnosis. We aimed to investigate if time from diagnosis to surgery is linked to short- and long-term outcomes.
Methods
An exploratory analysis was performed utilising a dedicated, prospectively populated database. Inclusion criteria were biopsy-proven colorectal adenocarcinoma undergoing elective laparoscopic surgery with curative intent. Demographics, date of diagnosis and surgery was captured with patients dichotomised using 4-, 8- and 12-week time points. All patients were followed in a standardised pathway for 5 years. Overall survival was assessed with the Kaplan-Meier log-rank method.
Results
Six hundred sixty-eight consecutive patients met inclusion criteria. Mean time from diagnosis to surgery was 53 days (95% CI 48.3–57.8). Identified risk factors for longer time to surgery were males (OR 1.92 [1.2–3.1],
p
= 0.008), age ≤ 65 (OR 1.9 [1.2–3],
p
= 0.01), higher ASA scores (
p
= 0.01) stoma formation (OR 6.9 [4.1–11],
p
< 0.001) and neoadjuvant treatment (OR 5.06 [3.1–8.3],
p
< 0.001). There was no association between time to surgery and BMI (
p
= 0.36), conversion (16.3%,
p
= 0.5), length of stay (
p
= 0.33) and readmission or reoperation (
p
= 0.3). No differences in five-year survival were seen in those operated within 4, 8 and 12 weeks (
p
= 0.397,
p
= 0.962 and
p
= 0.611, respectively). Multivariate analysis showed time from diagnosis to surgery was not associated with five-year overall survival (HR 0.99,
p
= 0.52).
Conclusion
Time from colorectal cancer diagnosis to curative laparoscopic surgery did not impact on overall survival. This finding may allow preoperative pathway alteration without compromising safety.</description><subject>Adenocarcinoma</subject><subject>Analysis</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Demography</subject><subject>Diagnosis</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Internal Medicine</subject><subject>Laparoscopic surgery</subject><subject>Laparoscopy</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Proctology</subject><subject>Risk factors</subject><subject>Short Communication</subject><subject>Surgery</subject><subject>Survival</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kc1u1TAQhS0EopfCA7BBltiwSfF_khWqKlqQKrEpa8sZT25dJXGwE6rueAiekCfB0S1UIJAXlu3vzBzPIeQlZyecsfptZkw2qmK8qSTjpmoekR1XUlRcGPGY7Biv24q3ujkiz3K-YeVsavWUHIlW10ozsyPLVRiR9imOFOIQE8LiBgpuAkzUB7efYg6ZLpEObnYpZohzAAprckv4ijSvaY_p7se37xt1jQmpo9n1SG_D5OMt7WOic8Jr14UhLEUUp3fPyZPeDRlf3O_H5PP5-6uzD9Xlp4uPZ6eXFSjZLpWpO18Xn6oH0znnsUUPukWhUagOvG6lEIJ1TgM3gKYTzOjOMwnSQ90oeUzeHOrOKX5ZMS92DBlwGNyEcc1WlMkZI8soC_r6L_Qmrmkq7jaq1kpryR6ovRvQhqmPS3KwFbWnNVeqKU1loU7-QZXlcQwQJ-xDuf9DwA8CKAPOCXs7pzC6dGc5s1vS9pC0LX7tlrRtiubVveG1G9H_VvyKtgDiAOTyNJWQHn70_6o_AXi0tKE</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Curtis, N. J.</creator><creator>West, M. A.</creator><creator>Salib, E.</creator><creator>Ockrim, J.</creator><creator>Allison, A. S.</creator><creator>Dalton, R.</creator><creator>Francis, Nader K.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5655-6823</orcidid></search><sort><creationdate>20180701</creationdate><title>Time from colorectal cancer diagnosis to laparoscopic curative surgery—is there a safe window for prehabilitation?</title><author>Curtis, N. J. ; West, M. A. ; Salib, E. ; Ockrim, J. ; Allison, A. S. ; Dalton, R. ; Francis, Nader K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-67bd77454fc6baade9edc59e25e24bcd5932220ba5c16ce6b2065bd03c3dc7843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adenocarcinoma</topic><topic>Analysis</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Demography</topic><topic>Diagnosis</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Internal Medicine</topic><topic>Laparoscopic surgery</topic><topic>Laparoscopy</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Patients</topic><topic>Proctology</topic><topic>Risk factors</topic><topic>Short Communication</topic><topic>Surgery</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Curtis, N. J.</creatorcontrib><creatorcontrib>West, M. A.</creatorcontrib><creatorcontrib>Salib, E.</creatorcontrib><creatorcontrib>Ockrim, J.</creatorcontrib><creatorcontrib>Allison, A. S.</creatorcontrib><creatorcontrib>Dalton, R.</creatorcontrib><creatorcontrib>Francis, Nader K.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Curtis, N. J.</au><au>West, M. A.</au><au>Salib, E.</au><au>Ockrim, J.</au><au>Allison, A. S.</au><au>Dalton, R.</au><au>Francis, Nader K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time from colorectal cancer diagnosis to laparoscopic curative surgery—is there a safe window for prehabilitation?</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>33</volume><issue>7</issue><spage>979</spage><epage>983</epage><pages>979-983</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Background
There is a growing interest in the adoption of formal prehabilitation programmes prior to elective surgery but regulatory targets mandate prompt treatment following cancer diagnosis. We aimed to investigate if time from diagnosis to surgery is linked to short- and long-term outcomes.
Methods
An exploratory analysis was performed utilising a dedicated, prospectively populated database. Inclusion criteria were biopsy-proven colorectal adenocarcinoma undergoing elective laparoscopic surgery with curative intent. Demographics, date of diagnosis and surgery was captured with patients dichotomised using 4-, 8- and 12-week time points. All patients were followed in a standardised pathway for 5 years. Overall survival was assessed with the Kaplan-Meier log-rank method.
Results
Six hundred sixty-eight consecutive patients met inclusion criteria. Mean time from diagnosis to surgery was 53 days (95% CI 48.3–57.8). Identified risk factors for longer time to surgery were males (OR 1.92 [1.2–3.1],
p
= 0.008), age ≤ 65 (OR 1.9 [1.2–3],
p
= 0.01), higher ASA scores (
p
= 0.01) stoma formation (OR 6.9 [4.1–11],
p
< 0.001) and neoadjuvant treatment (OR 5.06 [3.1–8.3],
p
< 0.001). There was no association between time to surgery and BMI (
p
= 0.36), conversion (16.3%,
p
= 0.5), length of stay (
p
= 0.33) and readmission or reoperation (
p
= 0.3). No differences in five-year survival were seen in those operated within 4, 8 and 12 weeks (
p
= 0.397,
p
= 0.962 and
p
= 0.611, respectively). Multivariate analysis showed time from diagnosis to surgery was not associated with five-year overall survival (HR 0.99,
p
= 0.52).
Conclusion
Time from colorectal cancer diagnosis to curative laparoscopic surgery did not impact on overall survival. This finding may allow preoperative pathway alteration without compromising safety.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29574506</pmid><doi>10.1007/s00384-018-3016-8</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-5655-6823</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2018-07, Vol.33 (7), p.979-983 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2018663007 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Adenocarcinoma Analysis Biopsy Cancer Care and treatment Colorectal cancer Colorectal carcinoma Demography Diagnosis Gastroenterology Hepatology Internal Medicine Laparoscopic surgery Laparoscopy Medical diagnosis Medicine Medicine & Public Health Multivariate analysis Patients Proctology Risk factors Short Communication Surgery Survival |
| title | Time from colorectal cancer diagnosis to laparoscopic curative surgery—is there a safe window for prehabilitation? |
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