Abstract
Although adjuvant chemotherapy is a standard treatment in stage III colon cancer, its benefit is not as clear for stage II patients. In this retrospective analysis, we aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease. One hundred and seventeen patients who were diagnosed with stage II colon cancer between January 2006 and December 2011 were included in the study. Patients were stratified into two groups as being low-risk and high-risk according to risk factors for stage II disease. Adjuvant 5-fluorouracil-based chemotherapy were administered to the patients with risk factors. Ninety-four patients were treated with adjuvant chemotherapy due to high risk factors and 23 were monitored without treatment. Median follow-up time was 43 months. In terms of disease free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Univariate analysis demonstrated that bowel obstruction was the major risk factor for shortened disease-free survival, while bowel perforation and perineural invasion were both negative prognostic factors for overall survival. The recommendation of adjuvant chemotherapy for stage II colon cancer is not clear. In our study, it was found that adjuvant chemotherapy did not contribute to survival in high-risk stage II patients. Due to the fact that prognosis of stage II patients is good, many more patients will be needed for statistically significant differences in survival. Adjuvant chemotherapy containing 5 fluorouracil is being used to high-risk stage II patients although it is not a standard treatment approach.
Highlights
Colorectal cancer is the third most frequent cause of cancer-related deaths both in women and men and the incidence 1.2 million /per year (Siegel et al, 2014; Ferlay et al, 2010)
We aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease
Despite the fact that adjuvant chemotherapy is not recommended for whole stage II colon cancer patients, it is well known that the majority of the previous adjuvant studies included an important number of stage II patients
Summary
Colorectal cancer is the third most frequent cause of cancer-related deaths both in women and men and the incidence 1.2 million /per year (Siegel et al, 2014; Ferlay et al, 2010). It is well known that the disease stage is the major prognostic factor for colorectal cancer. Surgery is the mainstay of curative intent for locoregional colorectal cancer and adjuvant chemotherapy is the standard recommended treatment for stage III colon cancer patients. Adjuvant chemotherapy is a standard treatment in stage III colon cancer, its benefit is not as clear for stage II patients. In this retrospective analysis, we aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease. Adjuvant chemotherapy containing 5 fluorouracil is being used to high-risk stage II patients it is not a standard treatment approach
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