Administration of adjuvant chemotherapy for stage <scp>II‐III</scp> colon cancer patients: An European population‐based study

Babaei, Mohammad; Balavarca, Yesilda; Jansen, Lina; Lemmens, Valery; Erning, Felice N. van; Eycken, Liesbet Van; Vaes, Evelien; Sjövall, Annika; Glimelius, Bengt; Ulrich, Cornelia M.; Schrotz‐King, Petra; Brenner, Hermann

doi:10.1002/ijc.31168

Cited by 42 publications

(40 citation statements)

References 39 publications

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“…The 5-year OS rates of MUA and NMUA were similar to previous report (19). More importantly, we showed again no survival difference between MUA and NMUA in stage II colon cancer, even in pT3 N0 M0 colon cancer with receipt of chemotherapy Despite clinical guidelines that had recommendations of adjuvant chemotherapy for high-risk colon cancer, the efficacy of adjuvant chemotherapy in high-risk disease had always been the subject of debate (22)(23)(24), indicating the necessity to identify candidates for adjuvant chemotherapy in stage II colon cancer. Few prior studies listed MUA as a high-risk factor.…”

Section: Discussionsupporting

confidence: 88%

Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer

Huang

et al. 2020

Front. Med.

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Background: It was a difficult question to identify candidates who would benefit most from adjuvant chemotherapy in stage II colon cancer because of the paucity of relevant conclusive clinical trial results. We aimed to assess if mucinous adenocarcinoma (MUA) could be an indicator for the efficacy of adjuvant chemotherapy in stage II colon cancer. Methods: Using SEER * Stat software V.8.3.5, eligible patients were then recruited from the SEER database. A χ 2 test was applied to compare the distribution of different categorical variables between nonmucinous adenocarcinoma (NMUA) and MUA groups. We then used the Kaplan-Meier method to analyze overall survival (OS) of different histological types in stage II colon cancer, and the log-rank test was then used to assess the OS differences. The Cox proportional regression risk models were also built in our analyses to eliminate potential crossed bias from other prognostic factors. Results: A total of 50,065 patients diagnosed with stage II colon cancer were recruited from the SEER database from 2004 to 2011; all the patients were divided into two groups, including NMUA (n = 44,785) and MUA (n = 5,280). The Cox analysis of the histological type indicated that the survival difference between MUA and NMUA failed to reach statistical significance in stage II colon cancer (P = 0.360). In NMUA, patients treated with adjuvant chemotherapy were independently associated with 37.2% decreased risk of overall mortality compared with those not [hazard ratio (HR) = 0.628, 95% confidence interval (CI) = 0.601-1.656, P < 0.001]; in MUA, the number increased to 41.5% (HR = 0.585, 95% CI = 0.515-0.665, P < 0.001). Conclusions: Our study showed that the survival difference between MUA and NMUA failed to reach statistical significance in stage II colon cancer. More importantly, our study had provided the first evidence that chemotherapy would offer higher survival improvement in MUA compared with NMUA in stage II colon cancer; mucinous histology might be an indicator for enhanced survival benefit of chemotherapy in stage II colon cancer.

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Section: Discussionsupporting

confidence: 88%

Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer

Huang

et al. 2020

Front. Med.

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“…[34] In addition to surgery, systemic therapy is an important treatment modality for regional CRC. [35] Studies have shown large variations in the use of adjuvant chemotherapy [36] and pre-operative radiotherapy [37] across countries. For example 56% of cases with Dukes' stage C colon cancers in the United States received chemotherapy while only 42% of cases with the same stage received chemotherapy in Northern Europe [38].…”

Section: Discussionmentioning

confidence: 99%

Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

Araghi

Arnold

Rutherford

et al. 2020

Gut

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ObjectivesAs part of the International Cancer Benchmarking Partnership (ICBP) SURVMARK-2 project, we provide the most recent estimates of colon and rectal cancer survival in seven high-income countries by age and stage at diagnosis.MethodsData from 386 870 patients diagnosed during 2010–2014 from 19 cancer registries in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK) were analysed. 1-year and 5-year net survival from colon and rectal cancer were estimated by stage at diagnosis, age and country,Results(One1-year) and 5-year net survival varied between (77.1% and 87.5%) 59.1% and 70.9% and (84.8% and 90.0%) 61.6% and 70.9% for colon and rectal cancer, respectively. Survival was consistently higher in Australia, Canada and Norway, with smaller proportions of patients with metastatic disease in Canada and Australia. International differences in (1-year) and 5-year survival were most pronounced for regional and distant colon cancer ranging between (86.0% and 94.1%) 62.5% and 77.5% and (40.7% and 56.4%) 8.0% and 17.3%, respectively. Similar patterns were observed for rectal cancer. Stage distribution of colon and rectal cancers by age varied across countries with marked survival differences for patients with metastatic disease and diagnosed at older ages (irrespective of stage).ConclusionsSurvival disparities for colon and rectal cancer across high-income countries are likely explained by earlier diagnosis in some countries and differences in treatment for regional and distant disease, as well as older age at diagnosis. Differences in cancer registration practice and different staging systems across countries may have impacted the comparisons.

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“…The role and efficacy of adjuvant chemotherapy for CRC have been well established. Modern chemotherapeutic regimens have been demonstrated to improve overall survival (OS), especially for stage II and III patients (3,4).…”

Section: Introductionmentioning

confidence: 99%

Stage II–III colon cancer: a comparison of survival calculators

Lemini

Attwood²,

Pecenka³

et al. 2018

J. Gastrointest. Oncol

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Background: Individualized postoperative survival calculators for patients with cancer can be an aid for predicting prognosis and clinical decision making, such as the use of adjuvant chemotherapy. The aim of this study was to compare existing survival calculators for colon cancer and determine their performance using an independent cohort of patients. Methods: A retrospective analysis of a multi-site institutional experience was performed on patients diagnosed with stage II-III colon cancer between January 2012 and March 2013. Patient survival rates were estimated using Roswell Park Comprehensive Cancer Center (RPCCC), Memorial Sloan Kettering Cancer Center (MSKCC), and MD Anderson Cancer Center (MDACC) calculators. These calculators vary in the number and breadth of variables that are included. The agreement between selected models was obtained through a scatter plot matrix and related intra-class correlation coefficient (ICC). Calculators' performances were compared using time-dependent receiver operating characteristic (ROC) curves and corresponding area under the curve (AUC) values. Results: After the application of inclusion and exclusion criteria, a total of 97 patients were included in the analysis. Survival data were available for all patients. Median follow-up was 57.6 months, and the overall 5-year survival rate was 0.74 (95% CI: 0.64-0.82). Overall, the different calculators tended to predict survival similarly (ICC =0.017). However, there was variation among calculator performance with the RPCCC calculator showing the highest performance (AUC =0.913), followed by the MSKCC calculator (AUC =0.803), and the MDACC calculator (AUC =0.644). Conclusions: Prognostic models incorporating a more comprehensive amount of patient and tumor specific variables may provide a more accurate estimate of individual patient survival rates. These tools can be an actual aid in the clinical practice, allowing physicians to personalize treatment and follow-up for patients with colon cancer.

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Administration of adjuvant chemotherapy for stage II‐III colon cancer patients: An European population‐based study

Cited by 42 publications

References 39 publications

Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer

Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer

Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

Stage II–III colon cancer: a comparison of survival calculators

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