ADVERTISEMENT
Researchers Study Value of Adjuvant Chemo for Stage II CRC
Guidelines for treatment of patients with stage II colorectal cancer (CRC) have recommended the use of adjuvant chemotherapy for T4 tumors. However, consensus has been lacking on whether adjuvant chemotherapy improves survival among other patients, including those with other high-risk characteristics.
In a recent study, researchers sought to determine whether adjuvant chemotherapy for stage IIA (T3N0) colon cancer showed benefit to patients. They reviewed the National Cancer Database (NCDB) to identify patients who had undergone colectomy for stage IIA colon adenocarcinoma from 2010 to 2015. Using inverse probability of treatment weighting (IPTW)‐adjusted Kaplan‐Meier and Cox proportional hazards regression analyses, the researchers compared overall survival between those who had received adjuvant chemotherapy with those who did not receive chemotherapy following colectomy. The study team also analyzed subgroups of patients with high‐risk features such as lymphovascular invasion, perineural invasion, and microsatellite instability.
Of 46,688 patients with stage IIA colon adenocarcinoma identified in the NCDB, 5937 (12.7%) received adjuvant chemotherapy, while 40,751 (87.3%) were observed. The IPTW‐adjusted survival over 5 years was 79.7% among patients who received adjuvant chemotherapy (95% CI 79.1, 80.2) compared to a 5-year survival rate of 70.3% (95% CI 69.7, 70.9) among the patients followed by observation only. Patients with high‐risk pathological features who received adjuvant chemotherapy showed a 5-year survival rate of 78.2% (95% CI 77.4, 79.1) vs 66.9% (95% CI 65.9, 67.8) among patients who were followed by observation.
“This NCDB analysis revealed a survival benefit for patients with stage IIA colon adenocarcinoma and high‐risk features that were treated with adjuvant chemotherapy,” the authors concluded.
--Rebecca Mashaw
Reference:
Achilli P, Crippa J, Grass F, et al. Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database. Int J Cancer. 2021;148(1): 161-169
