Adjuvant Therapy for High-Risk Stage II or III Colon Adenocarcinoma: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study

Abstract

Purpose: To determine the optimal adjuvant chemotherapy regimen for patients with high-risk stage II or III colon adenocarcinoma, we conducted this propensity score-matched, nationwide, population-based cohort study to estimate the effects of adjuvant treatments in high-risk stage II or III colon adenocarcinoma. Patients and Methods: Using propensity score matching, we minimized the confounding effects of sex, age, pathologic stage, tumor location, total chemotherapy cycles, and Charlson comorbidity index scores on adjuvant treatment outcomes in patients with high-risk stage II or III resectable colon adenocarcinoma. We selected the patients from the Taiwan Cancer Registry database and divided them into four groups: Group 1, comprising patients who received surgery alone; group 2, comprising those who received adjuvant fluoropyrimidine alone; group 3, comprising those who received adjuvant oxaliplatin-fluoropyrimidine-leucovorin (FOLFOX); and group 4, comprising those who received adjuvant folinic acid-fluorouracil-irinotecan (FOLFIRI). Results: In both univariate and multivariate Cox regression analyses, the adjusted hazard ratios (aHRs, as well as the 95% confidence intervals (Cis)) for mortality observed for groups 1, 2, and 4 relative to group 3 were 1.55 (1.32 to 1.82), 1.22 (1.05 to 1.43), and 2.97 (2.43 to 3.63), respectively. After a stratified subgroup analysis for high-risk stage II colon adenocarcinoma, we noted that the aHR (95% CI) for mortality for group 2 relative to group 3 was 0.52 (0.30 to 0.89). Conclusions: Adjuvant fluoropyrimidine alone is the most optimal regimen for patients with high-risk stage II colon adenocarcinoma compared with the other adjuvant chemotherapy regimens. Adjuvant FOLFOX can serve as an optimal regimen for patients with pathologic stage III colon adenocarcinoma, regardless of age, sex, or tumor location.

Effects of 1-Year Hospital Volume on Surgical Margin and Biochemical-Failure-Free Survival in Patients Undergoing Robotic versus Nonrobotic Radical Prostatectomy: A Nationwide Cohort Study from the National Taiwan Cancer Database

“…NHIRD data are additionally linked to the Death Registry to ascertain the vital status and the cause of death of each patient. TCRD of Collaboration Center of Health Information Application contains detailed patient information, such as clinical stages, surgical procedures, techniques, radiotherapy, hormone treatments, and pathologic stages [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

Latest Comprehensive Medical Resource Consumption in Robot-Assisted versus Laparoscopic and Traditional Open Radical Prostatectomy: A Nationwide Population-Based Cohort Study

“…The NHIRD includes all medical claims data on disease diagnoses, procedures, drug prescriptions, demographics, and enrollment profiles of all beneficiaries [ 27 ]. The TCRD of the Collaboration Center of Health Information Application contains detailed patient information, such as clinical stages, medical cost, treatment complication-related management, surgical procedures, techniques, radiotherapy, chemotherapy regimens and follow-up visits, and medical cost [ 3 , 4 , 28 , 29 , 30 , 31 , 32 , 33 ]. The medical marketplace is dynamic and constantly advancing [ 34 ].…”

SMYD3 promotes colon adenocarcinoma (COAD) progression by mediating cell proliferation and apoptosis

“…Targeted therapy is the most effective method to treat COAD (26). Numerous molecular targets of COAD have been discovered, including EGFR and sirtuin 6 (27,28). Targeted therapy drugs, including Gefitinib and Erlotinib, are on the market or are currently in clinical trials (29).…”