Timely rectal cancer treatment extends survival outcomes

The timing of rectal cancer treatment is crucial in improving patient survival, according to a study.

“Socioeconomic disparities limit timely treatment with attendant worse survival, supporting national homogenization of care,” the authors said. “As multimodal care for rectal cancer becomes increasingly complex, timely treatment remains paramount.”

Using the National Accreditation Program for Rectal Cancer (NAPRC), the authors identified 117,459 patients with stage I to III rectal cancer (median age 61 years) treated with curative-intent surgery from 2004 to 2020. They stratified patients into two cohorts (timely [<60 days] and delayed [≥60 days]) to analyse survival and to identify variables associated with timely treatment.

Of the patients, 61.1 percent were male, 86.2 percent were White, and 77.1 percent had Charlson comorbidity index (CCI) 0. In addition, 33.5 percent had stage II and 44.3 percent had stage III cancer treated initially with either chemoradiation (58.1 percent) or surgery (27.0 percent).

Timely treatment resulted in prolonged overall survival (OS; median 153.26 vs 128.59 months). Patients in the highest income bracket (odds ratio [OR], 1.30) with stage II (OR, 1.27) or III (OR, 1.50) cancer who received chemotherapy (OR, 2.24) or chemoradiation (OR, 1.73) as their first treatment were more likely to have timely treatment.

On the other hand, those with CCI ≥2 (OR, 0.83) of Black (OR, 0.56) or Hispanic (OR, 0.73) race had delayed treatment (p<0.01 for all).

“The NAPRC was established in 2017 to decrease rectal cancer treatment variation and improve oncologic outcomes,” the authors said. “Initiating curative intent treatment <60 days of first evaluation is one NAPRC standard.”