Prognostic Factor and Survival Benefit of Adjuvant Chemotherapy in Stage IIA Colon Cancer

Abstract

There is no clear evidence of the benefit of adjuvant chemotherapy (AC) in stage IIA colon cancer. Therefore, we aimed to evaluate the prognostic factors and survival benefit of AC in this disease. Methods: A retrospective data collection for patients who underwent radical surgery for colon cancer between January 2008 and December 2015 was undertaken. The cohort was divided into No AC and AC groups. Results: We included 227 patients with stage IIA colon cancer in our study cohort, including 67 and 160 patients in the No AC and AC groups, respectively. The number of retrieved lymph nodes and the presence of tumor complications as obstruction or perforation were independent risk factors for survival. In the No AC group, there was a significant difference in survival according to the number of retrieved lymph nodes. In the AC group, there were significant differences in survival according to sidedness and preoperative carcinoembryonic antigen (CEA). There was no significant difference in survival between the No AC and the AC groups. Conclusions: The number of retrieved lymph nodes and the presence of tumor complications were prognostic factors for stage IIA colon cancer but lymphovascular and perineural invasion were not. Sidedness and preoperative CEA could be used as factors to predict the benefit of adjuvant chemotherapy. Currently, it is believed that there is no benefit of AC for stage IIA colon cancer. Further studies are needed to determine the survival benefit of adjuvant chemotherapy in stage IIA colon cancer.

The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making

“…A combination of fluorouracil–oxaliplatin chemotherapy in the adjuvant setting provides a 30% relative risk reduction in disease recurrence and significantly improves overall survival (OS) [ 4 , 5 ]. While there is a consensus concerning adjuvant chemotherapy as standard treatment for stage III colon cancer, the benefits of adjuvant treatment for patients with lymph node-negative colorectal cancer remain controversial, particularly in stage IIA, which is T3N0 cancer [ 6 , 7 , 8 ]. Recent studies based on the National Cancer Database have reported on the OS benefit of adjuvant chemotherapy for patients with IIA colon cancer and high-risk prognostic features; however, the number of patients who received adjuvant chemotherapy was <50% and their performance status was not reported [ 6 , 9 ].…”

Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer

“…Because this study included stage II-III CRC patients, cancer status, including obstructive lesions and cancer infiltration, can influence postoperative inflammation and prognosis [41,42]. As shown in the ROC curves, the highest sensitivity of postoperative NPS compared with other scoring systems suggests that the patient's prognosis is influenced by multidisciplinary aspects of the biology of the primary tumor, the patient's nutritional status, and adequate postoperative management [43][44][45].…”

Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study

“…The number of retrieved lymph nodes, which has a significant impact on long-term oncological outcomes in advanced colorectal cancer, is important in achieving radical lymph node dissection. Lymph node dissection extent is of practical interest to colorectal surgeons [1][2][3]. The Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines recommend D3 lymph node dissection for stage II and III colorectal cancers, and D2 dissection for early-stage disease [4].…”