Role of chemotherapy in improving survival in stage IV colon cancer patients without surgery: An NCDB analysis.

Abstract

e15058 Background: Approximately 20% of patients with colorectal cancer have metastases at the time of presentation. Use of systemic chemotherapy for stage IV colon cancer has greatly increased over past several years with newer advancements. With advancements in chemotherapy annual rate of Primary tumor resection dropped from 74.5 percent in 1988 to 57.4 percent in 2010 with improved survival rates. Methods: A total of 39,428 patients with stage IV colon cancer were analyzed from the national cancer data base (NCDB). Differences in demographic and clinical co-variates were compared using Fisher’s exact test, where as survival differences were estimated by the Kaplan-Meier method and associated log-rank test; p < 0.05 indicated statistical significance. Results: The log-rank tests indicated statistically significant difference in survival (p < 0.001), such that patients receiving chemotherapy survived significantly longer (median survival = 12.0 months, 95% CI = 11.8 to 12.2 months) compared to patients not receiving chemotherapy (median survival = 1.5 months, 95% CI = 1.5 to 1.5 months). Patients receiving chemotherapy were younger (63.2 +/- 13.2 vs 73.8 +/- 13.0 ) with lesser co morbidity when compared to people who did not receive chemotherapy. Conclusions: Patients receiving chemotherapy are considerably younger, with less co-morbidity, and they survive significantly longer. This study signifies the survival advantage with chemotherapy in Stage IV colon cancer patients who did not get any type of surgery. Further studies need to be establish to define the role of chemotherapy comparing to surgery in stage 4 colon cancer patients.