Is it deleterious to delay the start of adjuvant chemotherapy in colon cancer stage III?
Postoperative chemotherapy using modulated 5-fluorouracil (5-FU) to patients operated for a colon cancer stage III can prevent recurrences in some individuals and thereby improve survival. These gains have been seen in randomised trials published 10–15 years ago. In the trials having a surgery-alone group, the treatment was generally initiated within 35 days, and the maximum number of days allowed was 56 [1–8]. In one trial, patients who did not start treatment within the stipulated 42 days were excluded [8]. In contrast, later trials comparing different regimen have allowed intervals up to 56 days or more [9–12]. In routine practice, this interval is frequently longer than in the trials. The potential importance of this interval was recently discussed [13]. Further, several abstracts at American Society of Clinical Oncology (ASCO) symposia in 2007 presented results from retrospective analyses [14–17]. The relevance of timing of adjuvant chemotherapy can for ethical reasons never be te
