T4 stage and preoperative anemia as prognostic factors for the patients with colon cancer treated with adjuvant FOLFOX chemotherapy.

Min Sung An,Jin Won Hwang,Bo Mi Kim,Kwang Hee Kim,Mi Seon Kang,Chang Soo Choi,Ki Beom Bae,Min Kyung Oh,Jong Han Yoo,Ji Hyun Kim,Kwan Hee Hong

doi:10.1186/s12957-015-0488-7

Min Sung An, Jin Won Hwang + Show 9 more

Open Access

https://doi.org/10.1186/s12957-015-0488-7

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Abstract

BackgroundFOLFOX-based adjuvant chemotherapy is a benefit for high-risk stage II and stage III colon cancer after curative resection. But, the prognostic factor or predictive marker for the efficacy of FOLFOX remains unclear. This study was aimed to identify the prognostic value and cumulative impact of adjuvant FOLFOX on the stage II and III colon cancer patients.MethodsA total of 196 stage II and III colon cancer patients were retrospectively enrolled in prospectively collected data. They underwent curative resection followed by FOLFOX4 adjuvant chemotherapy. The oncological outcomes included the 5-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate. Cox-regression analysis was performed to identify the prognostic value, and its cumulative impact was analyzed.ResultsThe 5-year DFS rate of the patients was 71.94% and the 5-year OS rate was 81.5%. The prognostic values for the 5-year DFS rate and 5-year OS rate were T4 stage and preoperative anemia in a multivariate analysis. Each patient group who had no prognostic value, single, or both factors revealed 95.35%, 69.06%, and 28.57% in the 5-year DFS rate, respectively (p < 0.0001). The 5-year OS rate also showed the significant differences in each group who had no prognostic value, single, or both factors revealed 100%, 79.3%, and 45.92%, respectively (p < 0.0001).ConclusionOur results showed similar efficacy to MOSAIC study in stage II and stage III colon cancer patients treated with adjuvant FOLFOX chemotherapy after curative resection. Patients who had T4 stage and/or preoperative anemia showed worse prognosis than patients without any prognostic value. These findings suggest that FOLFOX could not be effective in the patients with T4 stage colon cancer accompanied by preoperative anemia.

Highlights

FOLFOX-based adjuvant chemotherapy is a benefit for high-risk stage II and stage III colon cancer after curative resection
The stage of colon cancer were classified in accordance with the sixth edition of the American Joint Committee on Cancer (AJCC) TNM staging system, and the high-risk stage II and III patients who had been treated with adjuvant FOLFOX chemotherapy were enrolled
The 5-year overall survival (OS) rate showed the significant differences in each group who had no prognostic value, single, or both factors revealed 100%, 79.3%, and 45.92%, respectively (p < 0.0001) (Figure 3)

Summary

Introduction

FOLFOX-based adjuvant chemotherapy is a benefit for high-risk stage II and stage III colon cancer after curative resection. This study was aimed to identify the prognostic value and cumulative impact of adjuvant FOLFOX on the stage II and III colon cancer patients. The most important treatment for colon cancer is surgical resection. In the 1990s, O’Connell et al [4] reported low recurrence and mortality rates in patients with stage III colon cancer who had received. The Intergroup Trial (INT-0035) reported that administration of 5-FU and levamisole injections as adjuvant chemotherapy after surgery in patients with stage III colon cancer decreases the mortality rate by 33% [5]. Many reports suggested that a 5-FU and LV combination became the standard adjuvant treatment for stage III colon cancer [6,7]

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