Benefit of adjuvant chemotherapy in patients with T4 UICC II colon cancer

BMC Cancer

Research Article

Timo Itzel¹  Andreas Teufel¹  Janine Hartl¹  Christian Stroszczynski²  Stefan Fichtner-Feigl³  Hans Jürgen Schlitt³  Monika Klinkhammer-Schalke⁴  Michael Gerken⁴  Ferdinand Hofstädter⁴ 

[1] Department of Medicine I, University of Regensburg, Regensburg, Germany;Department of Radiology, University of Regensburg, Regensburg, Germany;Department of Surgery, University of Regensburg, Regensburg, Germany;Tumor Center, University of Regensburg, Regensburg, Germany;

关键词: Colon cancer;    Colorectal cancer;    Adjuvant therapy;    T4 stage;    UICC II;   

DOI  :  10.1186/s12885-015-1404-9

 received in 2014-12-09, accepted in 2015-04-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundColorectal cancer is the third most common cancer and a major cause of morbidity and mortality worldwide. Adjuvant chemotherapy is considered the standard of care in patients with UICC stage III colon cancer after R0 resection. Adjuvant therapy was not shown to be beneficial in patients with UICC stage II colon cancer. However, there is an ongoing discussion as to whether adjuvant chemotherapy may be beneficial for a subgroup of UICC II patients in a “high-risk situation” (such as T4).MethodsWe investigated a Bavarian population-based (2.1 million inhabitants) cohort of 1937 patients with UICC II CRC treated between 2002 and 2012 in regard of the benefit of adjuvant chemotherapy for large (T4) tumors. Patients older than 80 years of age were excluded. Of 1937 patients, 240 had a T4 tumor (12 %); 77 of all T4 patients received postoperative chemotherapy (33 %). Kaplan-Meier analysis and Cox regression models were used for survival analyses.ResultsPatients with a T4 tumor who received postoperative chemotherapy had a highly significant survival benefit in respect of overall survival (p < 0.001) and recurrence-free survival (p = 0.008). However, no difference was observed between oxaliplatin-containing and non-oxaliplatin-containing treatment regimens. G2 and G3 tumors were found to particularly benefit from adjuvant treatment. Chemotherapy, age at diagnosis, and tumor grading remained independent risk factors in the multivariate cox regression analysis.ConclusionOur retrospective study demonstrated the significant benefit of adjuvant chemotherapy in the T4 subgroup of patients with UICC II colon cancer. Our data suggest that adjuvant chemotherapy should be seriously considered in these patients.

【 授权许可】

CC BY   
© Teufel et al.; licensee BioMed Central. 2015