Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database
| Autor: | David W. Larson, Mohamed A. Abd El Aziz, Pietro Achilli, Courtney N. Day, Anne-Lise D. D'Angelo, Jacopo Crippa, William S. Harmsen, Fabian Grass, Kellie L. Mathis |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Adolescent Databases Factual Colorectal cancer medicine.medical_treatment Perineural invasion Datasets as Topic Subgroup analysis Kaplan-Meier Estimate Adenocarcinoma Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Stage (cooking) Pathological Colectomy Aged Neoplasm Staging Aged 80 and over Adenocarcinoma/diagnosis Adenocarcinoma/genetics Adenocarcinoma/mortality Adenocarcinoma/therapy Antineoplastic Combined Chemotherapy Protocols/therapeutic use Chemotherapy Adjuvant/statistics & numerical data Colonic Neoplasms/diagnosis Colonic Neoplasms/genetics Colonic Neoplasms/mortality Colonic Neoplasms/therapy Databases Factual/statistics & numerical data Female Follow-Up Studies Microsatellite Instability Middle Aged Treatment Outcome United States/epidemiology adjuvant chemotherapy colon adenocarcinoma high-risk features national cancer database overall survival business.industry Microsatellite instability Cancer medicine.disease United States Chemotherapy Adjuvant 030220 oncology & carcinogenesis Colonic Neoplasms business |
| Zdroj: | International journal of cancer, vol. 148, no. 1, pp. 161-169 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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