COLON cancer treatment interval up to 49 days did not worsen cancer-free survival after curative surgery.
Colon Cancer Treatment Interval and Survival
Extending the colon cancer treatment interval before curative surgery may be safe for selected patients, including those at elevated risk of postoperative complications, according to a retrospective multicenter analysis of 3,376 patients.
The study examined adults who underwent elective surgical treatment for stage I to III colon cancer between 2010 and 2016. Researchers assessed whether time from diagnosis to surgery was associated with overall survival or cancer-free survival, with patients stratified as high risk or non-high risk for postoperative complications.
Treatment interval was divided into three categories: 35 days or fewer, 36 to 49 days, and more than 49 days. Overall, 60% of patients were classified as non-high risk and 40% as high risk. Median age was 72 years, and disease stage was stage I in 26%, stage II in 40%, and stage III in 34%.
Cancer-Free Survival Was Not Compromised
Across both risk groups, cancer-free survival was not significantly affected by extending the colon cancer treatment interval. Neither a 36-to-49-day interval nor an interval longer than 49 days was associated with poorer cancer-free survival in high risk or non-high risk patients.
The findings support the possibility that a modestly longer diagnosis to surgery window may not carry the oncologic risk often assumed in curative colon cancer care. This is clinically relevant because current time targets can leave limited opportunity to implement prehabilitation before surgery.
Prehabilitation Window May Be Clinically Useful
Prehabilitation aims to improve physiologic and functional capacity before major surgery, particularly in older adults or patients with lower reserve. In colon cancer surgery, postoperative complications can impair recovery and survival, making preventive optimization especially important for high-risk patients.
A colon cancer treatment interval of 36 to 49 days was not associated with worse five-year overall survival in either risk group. However, an interval longer than 49 days was linked to poorer five-year overall survival in non-high risk patients, with a hazard ratio of 1.35. This association was not observed in high-risk patients.
These results suggest that extending the treatment interval up to 49 days may offer a practical window for prehabilitation without compromising cancer-free survival. For high-risk patients, clinicians may need to weigh the expected benefits of improved preoperative fitness against the medical urgency of proceeding to surgery.
Reference
Strous MTA et al. Treatment interval in curative treatment of colon cancer and its impact on (cancer-free) survival in high-risk and non-high-risk patients. J Geriatr Oncol. 2026;17(5):102993.
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