Assessment of adjuvant chemotherapy benefits after complete mesocolic excision in patients with colon cancer: Reanalysis of data from the ESCME trial

Abstract

Colon cancer is the fifth most common malignant disease worldwide, with 1 148 515 newly diagnosed cases and 576 858 deaths in 2020 [1]. Since fluoropyrimidine-based adjuvant chemotherapy (AC) was introduced in resected colon cancer in the 1990s [2], many wellknown clinical trials have shown that 6 months of AC with fluoropyrimidine alone decreased death risk by 10%-15% [3] and by an additional 5% [4] with oxaliplatin-containing combinations in Union for International Cancer Control (UICC) Stage III disease. As for UICC Stage II disease, AC survival benefits were <5% [3], which was only appropriate for situations with high-risk factors [5]. In addition, recent studies [6, 7] showed that reducing the AC period by 3 months obtained similar survival and was significantly less toxic than the 6-month strategy. The technique of colon cancer surgery has been completed and standardized since Hohenberger et al. [8] proposed complete mesocolic excision (CME) by combining lymphatic

Safety and Efficacy of Laparoscopic Surgery versus Open Surgery in Elderly Patients with Colon Cancer: A Propensity Score Matching Cohort Study

“…The diagnosis of postoperative complications depended on the medical record, and only surgical complications of grade II or above of the Clavien-Dindo Classification of Surgical Complications [12] were collected. Adjuvant chemotherapy was not recommended routinely following Chinese guidelines [13, 14] and our clinical practice [15, 16], with the exception of several patients with advanced diseases, in whom the administration was based on the individual surgeon’s advice.…”