Delaying definitive resection in early stage (I/II) colon cancer appears safe up to 6 weeks

Davidson, Jesse T.; Abelson, Jonathan S.; Glasgow, Sean C.; Hunt, Steven R.; Mutch, Matthew G.; Wise, Paul E.; Silviera, Matthew L.; Smith, Radhika K.

BACKGROUND: The objective of this study was to determine if there is an impact of surgical delay on 5-year overall survival (OS) from early stage colon cancer, and if so, to define how long surgery can safely be postponed. METHODS: Using the NCDB, we compared early (14–30 days) and delayed surgery (31–90 days) in patients with Stage I/II colon cancer. Outcomes included OS at five years and odds of death. RESULTS: Delayed resection conferred a decreased 5-year OS of 73.0% (95% CI, 72.6–73.4), compared to early resection 78.3% (95% CI, 77.9–78.8). When time to surgery was divided into one-week intervals, there was no difference in the odds of death with delay up to 35–41 days (6 weeks), but odds of death increased by 9% per week thereafter. CONCLUSIONS: These data support that definitive resection for early stage colon cancer may be safely delayed up to 6 weeks.