Adjuvant Chemotherapy Improves Colon Cancer Outcomes

Adjuvant chemotherapy may improve survival in patients with stage II colon cancer regardless of treatment regimen, patient age, or high-risk pathologic features, according to a study published in the journal Cancer.

The role of adjuvant chemotherapy in the management of stage II colon cancer is still unclear and its use varies significantly across patients and institutions, with current guidelines suggesting that it be discussed only with patients who have high-risk stage II disease and when there is an absence of conclusive randomized controlled trial data.

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To clarify the role of adjuvant chemotherapy in patients with stage II colon cancer, researchers led by Ajay V Maker, MD, University of Illinois at Chicago, conducted a study investigating the relationship between its use and overall survival in patients stratified by age and pathological features.

They used data from the National Cancer Data Base to analyze the demographics, tumor characteristics, management, and survival of patients with stage II colon cancer diagnosed between 1998 and 2006 with survival information through 2011. Statistical analyses were then used to analyze demographic and survival data.

A total 153,110 patients with stage II colon cancer were included in the analysis. Male sex, nonwhite race, age younger than 65 years, use of a community treatment facility, non-Medicare insurance, and diagnosis before 2004 were associated with receipt of chemotherapy. Researchers also found that adjuvant chemotherapy led to improved and clinically relevant overall survival in all patient subgroups, regardless of high-risk tumor pathologic features, age, or chemotherapy regimen. Further, no difference in single or multiagent adjuvant chemotherapy regimens was observed.

Thus researchers concluded that adjuvant chemotherapy may improve survival in patients with stage II colon cancer regardless of demographic or pathologic features. Their study also included the largest group of patients with stage II colon cancer ever evaluated, according to the researchers.