TITLE:
Efficacy of Postoperative Adjuvant Chemotherapy According to Prognostic Factor in Patients with Stage III Colon Cancer
AUTHORS:
Kiichi Sugimoto, Kazuhiro Sakamoto, Yuichi Tomiki, Michitoshi Goto, Yutaka Kojima, Hiromitsu Komiyama, Makoto Takahashi, Shun Ishiyama, Koichiro Niwa, Haruna Okubo
KEYWORDS:
Colorectal Cancer, Postoperative Adjuvant Chemotherapy, Prognostic Factor, Stage III Colon Cancer, TNM Classification, 7th Edition
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.8,
July
21,
2014
ABSTRACT: Background: We
retrospectively identified prognostic factors in patients with Stage III colon
cancer and considered the effectiveness of postoperative adjuvant chemotherapy
based on these prognostic factors. Methods: Two hundred and thirty four
patients with lymph node metastases who underwent curative surgery for colon
cancer between 1999 and 2005 were enrolled in the present study. Firstly,
clinicopathological factors and survival data, were analyzed to determine
prognostic factors related to cancer-specific survival. Secondly, we examined
the effectiveness of postoperative adjuvant chemotherapy based upon these
prognostic factors. Results: The multivariate analysis revealed that differentiation
(P = 0.03, Hazard ratio = 2.50), lymphatic invasion (P = 0.02, Hazard ratio =
3.23) and the TNM classification, 7thedition (P = 0.04, Hazard ratio =
1.94) were found to be significant independent prognostic factors. Among the
patients classified as TNM IIIA, the recurrence-free survival rates were
extremely good. Among the patients classified as IIIB and IIIC, there was no
significant difference between the patients with and without postoperative
adjuvant chemotherapy. Conclusion: The present study suggests that the patients
with Stage IIIA colon cancer may not require postoperative adjuvant
chemotherapy. The addition of oxaliplatin to 5-FU should be considered for the
patients with Stage IIIB and IIIC colon cancer, for whom the prognoses are far from
satisfactory.