Abstract
To date, the effect of adjuvant chemotherapy after curative resection in patients with stage II colon cancer remains controversial. Still, little is known about the effects of adjuvant chemotherapy in patients with stage II colon cancer who are older than 70 years, as most studies did not focus on this population. This study aimed to investigate the oncologic outcomes of elderly patients with stage II colon cancer who underwent curative resection with or without postoperative adjuvant chemotherapy. We retrospectively reviewed medical records of patients older than 70 years who underwent curative resection of stage II primary colon cancer during 2002–2015. Patients were classified into surgery alone (SA) and adjuvant chemotherapy (AC) groups and propensity score-matched at a 1:1 ratio using a logistic regression. The end points were recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS). Of the 623 patients who met the criteria, 145 were assigned to each arm after propensity score matching. The mean ages of the SA and AC groups were 74.3 and 74.0 years, respectively. A log-rank test revealed no significant inter-group differences in RFS (p = 0.202), CSS (p = 0.486) or OS (p = 0.299). In a Cox regression analysis, adjuvant chemotherapy was not found to be an independent factor affecting RFS (p = 0.206), CSS (p = 0.487) or OS (p = 0.301). Adjuvant chemotherapy does not appear to yield survival benefits in elderly patients with stage II colon cancer.
Highlights
The number of elderly patients diagnosed with colon cancer continues to increase worldwide, in parallel with population aging[1]
As most previous studies did not focus on patients older than 70 years, little information is available about the potential benefits of adjuvant chemotherapy for stage II colon cancer in this population
We retrospectively reviewed the medical records of patients older than 70 years who underwent curative resection of stage II primary colon cancer at Seoul National University Hospital from 2002 to 2015
Summary
The number of elderly patients diagnosed with colon cancer continues to increase worldwide, in parallel with population aging[1]. In one study of data from Medicare and the Texas Cancer Registry, Zhao and colleagues reported that guideline-concordant treatment, including adjuvant chemotherapy, was associated with better survival outcomes among elderly patients with stage II and stage III colon cancer[4]. The effect of adjuvant chemotherapy after curative resection in stage II colon cancer patients remains controversial. We aimed to investigate the oncologic outcomes, including recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS), in elderly patients with stage II colon cancer who underwent curative resection with or without adjuvant chemotherapy. We hypothesize that these two groups of patients would achieve different survival outcomes
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