Effect of Adjuvant Chemotherapy on Stage II Colon Cancer: Analysis of Korean National Data
Cancer Research and Treatment 2018³â 50±Ç 4È£ p.1149 ~ p.1163
±è¹Î±â(Kim Min-Ki) - Catholic University College of Medicine Seoul St. Mary¡¯s Hospital Department of Surgery
¿ø´ë¿¬(Won Dae-Youn David) - Catholic University College of Medicine Seoul St. Mary¡¯s Hospital Department of Surgery
¹Ú¼±¹Î(Park Sun-Min) - Catholic University College of Medicine Seoul St. Mary¡¯s Hospital Department of Surgery
±èÅÂÁ¤(Kim Tae-Jung) - Catholic University College of Medicine Seoul St. Mary¡¯s Hospital Department of Surgery
±è¼º¿ë(Kim Sung-Ryong) - Catholic University College of Medicine Seoul St. Mary¡¯s Hospital Department of Surgery
¿À¼ºÅÃ(Oh Seong-Taek) - Catholic University College of Medicine Uijeongbu St. Mary¡¯s Hospital Department of Surgery
¼Õ½Â±¹(Sohn Seung-Kook) - Health Insurance Review and Assessment Service
°¹Ì¿¬(Kang Mi-Yeon) - Health Insurance Review and Assessment Service
ÀÌÀαÔ(Lee In-Kyu) - Catholic University College of Medicine Seoul St. Mary¡¯s Hospital Department of Surgery
Abstract
Purpose: Debates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data.
Materials and Methods: A total of 7,880 patientswho underwent curative resection for stage II colon adenocarcinoma between January 2011 andDecember 2014 in Koreawere selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage.
Results: The median follow-up period was 38 months (range, 1 to 63 months). Chemotherapy was a favorable prognostic factor for either the high- (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.38 to 0.59; p < 0.001) or low-risk group (HR, 0.74; 95% CI, 0.61 to 0.89; p=0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn¡¯t receive chemotherapy. Adding oxaliplatin showed no difference in survival (HR, 1.36; 95% CI, 0.91 to 2.03; p=0.132).
Conclusion: Adjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.
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Adjuvant chemotherapy, Colonic neoplasms, Treatment outcome
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The most important result of this study was that AC was revealed to have favorable effect on survival for Korean stage II colon cancer patients regardless of their high- or low-risk group assignments.