Efficacy of systemic Chemotherapy on high-risk stage II and III Mucnious colon cancer. CHEMUCCA study part I.

Autor: Trinidad-Gutiérrez I; Surgical Oncology Unit, Reina Sofia University Hospital, Córdoba, Spain., Vázquez-Borrego MC; GE09 Peritoneal and Retroperitoneal Oncologic Surgery Research Group, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain; Department of Biochemistry and Molecular Biology, University of Cordoba, Córdoba, Spain., Aguilera-Fernández E; Surgical Oncology Unit, Reina Sofia University Hospital, Córdoba, Spain., Velez-Castaño JE; Surgical Oncology Unit, Reina Sofia University Hospital, Córdoba, Spain., Muriel-López CE; Surgical Oncology Unit, Reina Sofia University Hospital, Córdoba, Spain., Rodríguez-Ortíz L; Surgical Oncology Unit, Reina Sofia University Hospital, Córdoba, Spain; GE09 Peritoneal and Retroperitoneal Oncologic Surgery Research Group, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain., Gómez A; Department of Computer Science and Numerical Analysis, University of Cordoba, Spain., Berchez-Moreno F; Department of Computer Science and Numerical Analysis, University of Cordoba, Spain., Hervás C; Department of Computer Science and Numerical Analysis, University of Cordoba, Spain., Romero-Ruiz A; GE09 Peritoneal and Retroperitoneal Oncologic Surgery Research Group, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain; Department of Biochemistry and Molecular Biology, University of Cordoba, Córdoba, Spain., Arjona-Sánchez Á; Surgical Oncology Unit, Reina Sofia University Hospital, Córdoba, Spain; GE09 Peritoneal and Retroperitoneal Oncologic Surgery Research Group, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain. Electronic address: alvaroarjona@hotmail.com.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Nov; Vol. 50 (11), pp. 108642. Date of Electronic Publication: 2024 Aug 24.
DOI: 10.1016/j.ejso.2024.108642
Abstrakt: Background: Locally advanced colon cancer is a high-risk condition for tumour recurrence with poor survival. The current treatment is surgery followed by adjuvant chemotherapy based on fluoropyrimidines and oxaliplatin. This approach has improved the oncological outcomes on this population, however the mucinous condition has not been studied in depth and although the evidence is weak, it is thought to have a worse response to systemic chemotherapy. The CHEMUCCA study aims to answer this question.
Objective: To evaluate the effectiveness of adjuvant systemic chemotherapy using the disease-free survival for stage II and III mucinous colon cancer who underwent surgical resection plus systemic adjuvant chemotherapy vs. surgery alone.
Patients and Methods: Retrospective analytical study including patients diagnosed with high-risk stage II and stage III colon cancer, treated between 2010 and 2021, with a minimum follow-up of 3 years. Demographic variables and tumour features were analysed. The primary endpoint was disease-free survival. Log rank test and Cox regression were used.
Results: Of 1134 patients with high-risk stage II and III colon cancer disease, 206 (18,17 %) had mucinous histology and 928 (81,83 %) had non-mucinous histology. 708 patients who received adjuvant chemotherapy, 129 (62,62 %) in mucinous group and 579 (62,39 %) in the non-mucinous group. Adjuvant systemic chemotherapy in stage II and III mucinous colon cancer improved the DFS (HR = 0.58 [95 % CI 0.37-0.91]; p = 0,017). However, in a stratified analysis, patients with high-risk stage II mucinous colon cancer showed no benefit with this approach (HR = 0.4541 [95 % CI 0.19-1.03]; p = 0.06).
Conclusion: Adjuvant chemotherapy has demonstrated to be effective in locally advanced mucinous colorectal cancer improving the oncological outcomes. However, this benefit could be diminished in high-risk stage II mucinous colon cancer patients. The administration of adjuvant chemotherapy on this patient's sub-group must be balanced according to risk versus benefits.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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