关键词: 结直肠肿瘤, 手术后并发症, 放化疗, 辅助, 预后

Abstract: Objective  To gain access to the suitable interval of postoperative adjuvant chemotherapy(PAC) for stage Ⅲ colorectal cancer patients by metaanalysis and identify the effects of postoperative complications on interval  as well.  Methods  Casecontrol studies assessing the interval time between curative resection surgery and first PAC for Ⅲ CRC patients  were identified from Cochrane Library, PubMed, Web of Science, China National Knowledge Internet(CNKI). Overall Survival(OR),  RelapseFree Survival(RFS),  as well as the associations between postoperative complications and interval were concluded and statistically analyzed by Forest Plot.Results  Eleven casecontrol studies which covered a total of 47 775 patients（26 499 males；21 276 females）were contained in this  metaanalysis.  We chose eight weeks for the cutoff,beyond which was related to worse OS（OR=1.75；95% CI=1.352.25,P<0.01）. If a variety of cutoffs were included,longer delay was similarly associated to a worse OS（OR=1.55,95%CI=1.231.93,P=0.0001）,  but not a worse RFS（P=0.10). Postoperative complications became a key point of the delays of PAC（OR=2.43,95%CI=1.194.96,P=0.01）. Conclusion  The first PAC should be performed within eight weeks in patients with stage Ⅲ colorectal cancer. Delayed PAC results in poor OS, while RFS has no significant impact. Effective control of postoperative complications is a necessary factor to ensure PAC on schedule.

Key words: colorectal neoplasm；postoperative complications； adjuvant , chemoradiotherapy；prognosis