The influence of neoadjuvant chemotherapy cycles on surgical complications in metastatic colon cancer

This study aimed to evaluate the impact of the number of preoperative chemotherapy cycles on postoperative complications in patients with metastatic colon cancer. A total of 107 eligible patients with initially potentially resectable disease who received preoperative chemotherapy between 2008 and 2021 were retrospectively included in the analysis. The optimal cut-off of six cycles for predicting postoperative complications was determined by receiver operating characteristic (ROC) curve analysis. Patients who received more than six cycles of chemotherapy had a significantly higher complication rate compared with those who received six cycles or fewer (58.2 ​% vs. 17.5 ​%, p ​= ​0.001). Multivariate analysis confirmed chemotherapy cycles as an independent predictor of surgical complications (odds ratio ​= ​5.91, p ​= ​0.002). These findings suggest that exceeding six cycles of chemotherapy before surgery increases postoperative risks. Surgical evaluation after six cycles may reduce morbidity and guide optimal treatment timing for patients with metastatic colon cancer.