Abstract
3605 Background: Few population-based analyses on treatment outcomes of colorectal cancer (CRC) have been conducted in Asian countries. We conducted a nationwide study to assess relationship between timing and duration of adjuvant chemotherapy (AC) and survival for patients with CRC in South Korea. Methods: Data from the Health Insurance Review and Assessment Service Database (HIRA) were analyzed for demographics, tumor characteristics, adjuvant chemotherapy, and survival of patients who underwent curative-intent surgical resection for CRC from 2011 to 2014. Results: From the HIRA data, a total of 61315 patients were identified: 15620 (25.5%) in stage I, 20525 (33.5%) in Stage II, and 25170 (41.0%) in stage III. Chemotherapy regimens were consisted: 11332 (18.5%) in 5-fluorouracil and leucovorin/capecitabine (FL/CAP), 13183 (21.5%) in FL/CAP plus oxaliplatin (FOLFOX/CAPOX), 357 (0.6%) in uracil and tegafur/doxifluridine (UFT/D) and 36443 (59.4%) in surgery alone. For patients with stage II and III CRC, the initiation of AC ≥ 8 weeks after surgery was associated with a significant decrease in overall survival (OS) (FL/CAP: HR, 1.82; 95% CI, 1.53 to 2.17, and FOLFOX/CAPOX: HR, 2.92; 2.47 to 3.45, respectively), however UFT/D regimens were not statistically significant. For patients with stage II and III colon cancer, receiving AC < 3 months had lower OS (FL/CAP: HR, 3.72; 95% CI, 2.80 to 4.94, FOLFOX/CAPOX: HR, 2.15; 1.87 to 2.47, and UFT/D: HR, 1.74; 0.56 to 5.41, respectively). For patients with stage II and III rectal cancer, receiving AC < 3 months regardless of chemotherapy regimens had a significant lower survival (FL/CAP: HR, 1.91; 1.66 to 2.20, FOLFOX/CAPOX: HR, 2.20; 1.75 to 2.77, and UFT/D: HR, 3.71; 1.45 to 9.44, respectively). Conclusions: Time to initiation and duration of AC after surgery were associated with survival. Based on our results, starting within 8 weeks and receiving more than 3 months of AC are needed to have an overall survival benefit.
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