Abstract:
Objective This study aims to prove the survival advantage given to patients with stage Ⅱ colon cancer through chemotherapy.
Methods The clinical and pathological data of stage Ⅱ colon cancer patients with radical resection from January 2005 to December 2008 were retrospectively evaluated.The difference in disease-free survival(DFS) and the overall survival(OS) between patients who received oxaliplatin and fluorouracil as adjuvant treatment(n=155) and those who did not receive adjuvant chemotherapy(n=111) were compared.The χ2 and two-way analysis of variance were used to assess the difference in patient-and disease-related characteristics.The overall and five-year disease-free survival data were examined using the Kaplan-Meier survival analysis and Cox proportional hazards regression with propensity score weighting.
Results The five-year DFS rates were 90.2% and 86.5% in the adjuvant treatment and surgical only groups, respectively(HR=0.59, 95% CI 0.295-1.208, P=0.152).The five-year OS rates were 92.9% and 88.3% in the adjuvant treatment and surgical only group, respectively(HR=0.576, 95% CI 0.248-1.338, P=0.199).No survival benefit was observed in patients with stage Ⅱ colon cancer.Patients with T4 stage, poor histology, more than one high risk factor, or carcinoembryonic antigen(CEA) > 5 ng/ml had higher five-year DFS through adjuvant chemotherapy.
Conclusion Oxaliplatin and fluorouracil adjuvant treatment did not substantially improve the DFS and OS of all patients with stage Ⅱ colon cancer.However, patients with T4 stage, poor histology, more than one high risk factor, or CEA > 5 ng/ml could benefit from adjuvant chemotherapy.
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