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Stage II colon cancer: Epidemiological, clinical characteristics, and therapeutic results. Experience of the medical oncology department of Fez
Background
Adjuvant chemotherapy is recommended in patients with stage II colon cancer with high-risk features. The objective of our study is to assess survival benefits associated with adjuvant chemotherapy among stage II colon cancer patients having one or more high risk features [T4 tumors, less than 12 lymph nodes examined (< 12LN), positive margins, high-grade tumor, perineural invasion, and lymphovascular invasion)].
Methods
This is a retrospective study of 144 patients with stage II colon cancer treated at the medical oncology department of Fez over a period from December 2009 to September 2020. The Kaplan Meier method was used to estimate the median survival. This is a retrospective study of 144 patients with stage II colon cancer treated at the medical oncology department of CHU Hassan II in Fez over a period from December 2009 to September 2020. The Kaplan Meier method was used to estimate the median survival.
Results
65% (n= 93) of patients received postoperative chemotherapy and included 44 %males 56%females. MSI observed in 25 % (n=36 ) of patients versus Mss in 38 % (n=56) of patients. 14.8% of patients had an occlusion and 18% had perforations. T4 tumors observed in 22.4% of patients. Median overall survival for MSI patients was 36 months versus 29 months for MSS patients. 88% of patients with MSS status and risk factors received chemotherapy with a median survival of 29 months. Chemotherapy was relatively well tolerated on the hematological and digestive level. The acute toxicities observed were essentially grade 1 or 2. They essentially consisted of vomiting and diarrhea in 25% of cases, peripheral neuropathy in 21.5% of cases and neutropenia in 8.5% of cases.
Conclusions
The decision to treat a patient with stage II colon cancer with adjuvant chemotherapy can be challenging. Our study showed an increased overall survival in patients with MSI. However, the indication of this chemotherapy should always take into consideration the risk-benefit for each patient.
Legal entity responsible for the study
The author.
Funding
Department oncology of Fez.
Disclosures
All authors have declared no conflicts of interest.
