Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database.

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Version: Final published version
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Serval ID
serval:BIB_0BFC462249D2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database.
Journal
International journal of cancer
Author(s)
Achilli P., Crippa J., Grass F., Mathis K.L., D'Angelo A.D., Abd El Aziz M.A., Day C.N., Harmsen W.S., Larson D.W.
ISSN
1097-0215 (Electronic)
ISSN-L
0020-7136
Publication state
Published
Issued date
08/08/2020
Peer-reviewed
Oui
Volume
148
Number
1
Pages
161-169
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Utility of adjuvant chemotherapy for stage II cancer remains a matter of debate. Clinical guidelines suggest adjuvant chemotherapy for stage II tumors with high-risk features, in particular T4 tumors. However, limited consensus exists regarding the importance of other high-risk features (lymphovascular or perineural invasion, microsatellite instability). Our study aimed to investigate the impact of adjuvant chemotherapy for stage IIA (T3N0) colon cancer patients. Patients who underwent colectomy for stage IIA colon adenocarcinoma (2010-2015) were identified in the National Cancer Database (NCDB) and divided in two groups based on receipt of adjuvant chemotherapy vs observation. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier and Cox proportional hazards regression analyses were performed to compare overall survival between the two groups. Subgroup analysis of patients with specific high-risk features LVI, PNI and MSI was performed. Among 46 688 surgical patients with stage IIA colon adenocarcinoma 5937 (12.7%) received adjuvant chemotherapy, while 40 751 (87.3%) were observed. Five-year IPTW-adjusted survival was higher in the adjuvant chemotherapy group (79.7% [95% CI 79.1, 80.2]) compared to the observation group (70.3% [95% CI 69.7, 70.9]). Patients with high-risk pathological features showed an estimated 5-year survival benefit of 11.3% (78.2% [95% CI 77.4, 79.1] vs 66.9% [95% CI 65.9, 67.8]) when treated with adjuvant chemotherapy. This NCDB analysis revealed a survival benefit for patients with stage IIA colon adenocarcinoma and high-risk features that were treated with adjuvant chemotherapy.
Keywords
Adenocarcinoma/diagnosis, Adenocarcinoma/genetics, Adenocarcinoma/mortality, Adenocarcinoma/therapy, Adolescent, Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Chemotherapy, Adjuvant/statistics & numerical data, Colectomy, Colonic Neoplasms/diagnosis, Colonic Neoplasms/genetics, Colonic Neoplasms/mortality, Colonic Neoplasms/therapy, Databases, Factual/statistics & numerical data, Datasets as Topic, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Microsatellite Instability, Middle Aged, Neoplasm Staging, Treatment Outcome, United States/epidemiology, Young Adult, adjuvant chemotherapy, colon adenocarcinoma, high-risk features, national cancer database, overall survival
Pubmed
Web of science
Open Access
Yes
Create date
29/11/2021 13:10
Last modification date
30/11/2021 7:08
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