Abstract
Background: We retrospectively identified prognostic factors in patients with Stage III colon cancer and considered the effectiveness of postoperative adjuvant chemotherapy based on these prognostic factors. Methods: Two hundred and thirty four patients with lymph node metastases who underwent curative surgery for colon cancer between 1999 and 2005 were enrolled in the present study. Firstly, clinicopathological factors and survival data, were analyzed to determine prognostic factors related to cancer-specific survival. Secondly, we examined the effectiveness of postoperative adjuvant chemotherapy based upon these prognostic factors. Results: The multivariate analysis revealed that differentiation (P = 0.03, Hazard ratio = 2.50), lymphatic invasion (P = 0.02, Hazard ratio = 3.23) and the TNM classification, 7th edition (P = 0.04, Hazard ratio = 1.94) were found to be significant independent prognostic factors. Among the patients classified as TNM IIIA, the recurrence-free survival rates were extremely good. Among the patients classified as IIIB and IIIC, there was no significant difference between the patients with and without postoperative adjuvant chemotherapy. Conclusion: The present study suggests that the patients with Stage IIIA colon cancer may not require postoperative adjuvant chemotherapy. The addition of oxaliplatin to 5-FU should be considered for the patients with Stage IIIB and IIIC colon cancer, for whom the prognoses are far from satisfactory.
Highlights
Colorectal cancer is the second most common cause of cancer death in the United States and Japan, and its incidence is rapidly increasing in Japan [1] [2]
Stage III colon cancer is suitable for postoperative adjuvant chemotherapy, and intravenous Fluorouracil and Leucovorin therapy has been the therapeutic standard in the surgical adjuvant setting
We retrospectively identified prognostic factors in patients with Stage III colon cancer and considered the effectiveness of postoperative adjuvant chemotherapy based on these prognostic factors
Summary
Colorectal cancer is the second most common cause of cancer death in the United States and Japan, and its incidence is rapidly increasing in Japan [1] [2]. Many guidelines in the West recommend postoperative adjuvant chemotherapy with oxaliplatin for patients with Stage III colon cancer [7]-[9]. It is extremely important to distinguish those Stage III patients for whom postoperative adjuvant chemotherapy with oxaliplatin may be unnecessary. We retrospectively identified prognostic factors in patients with Stage III colon cancer and considered the effectiveness of postoperative adjuvant chemotherapy based on these prognostic factors. Conclusion: The present study suggests that the patients with Stage IIIA colon cancer may not require postoperative adjuvant chemotherapy. The addition of oxaliplatin to 5-FU should be considered for the patients with Stage IIIB and IIIC colon cancer, for whom the prognoses are far from satisfactory
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