Benefit of adjuvant chemotherapy in patients with stage II colon cancer: A Retrospective study
Osama Hashem Abdulhameed Abdulazez;
Abstract
Colorectal cancer is the fourth most frequently diagnosed cancer and the second leading cause of cancer death in the United States.Colon cancer represents the 7th rank among the 10 most common cancer sites in Egypt , accounts for 4.7% of all incident cancer cases in Egypt .
The Aim of this retrospective stud was to estimate the benefit of adjuvant chemotherapy for patients with stage II colon cancer .
Trial Design : include patients with colon cancer stage II who underwent surgery , in the period from January 2010 to December 2015 in Ain Shams university Hospital. patients received adjuvant Chemotherapy were compared to those who had received no treatment .
Results : The study included sixty-seven patients . The mean age for all patients was 57 years. Thirty-nine patients received adjuvant chemotherapy due to being considered as high risk and twenty-eight low risk patients were followed up without treatment . Median follow up time was 16 months . patients who received adjuvant chemotherapy had median Overall survival 53 months vs 49 months in those who did not (P= 0.921) and median Relapse free survival 37 months vs 26 months (P= 0.145) . In terms of Relapse free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Within the adjuvant group, the most frequent poor prognostic features included: suboptimal lymph node sampling 64% ,clinical obstruction or perforation 31% , T4 invasion 23% ,lymphovascular invasion 10% and poor differentiation 5% .
When the effects of the significant Variables on death risk were investigated by multivariate analyses , No statistically significant overall survival differrance could be detected among those variables : Age (HR,0.902; 95%CI, 0.204-4.053 [P=0.906]) Lymphovascular invasion (HR,0.271; 95%CI, 0.176-0.237 [P=0.321]) , suboptimal LN resection (HR, 1.866; 95%CI, 1.213-1.637 [P=0.671] ) . However, Significant survival difference demonstrated in : clinical obstruction at diagnosis (HR, 4.630; 95%CI, 2.750-3.712 [P=0.054]) had significant shorter OS , T4 tumors (HR0.181 95%CI 0.118-0.159 [P=0.041]) had significant improvement of OS and Sidedness ,and patients with right sided colon cancer had a small significant improved overall survival (HR 0.85 95% CI 0.75–0.98, p = 0.033) than left sided patients .
No statistically significant RFS differrance could be detected among those variables : age [HR], 1.00; 95%CI, 0.437-2.536 [P=0.805]), suboptimal LN resection (Hazard Ratio [HR], 0.614; 95%CI, 0.399-0.539 [P=0.658]) and Lympho-vascular invasion( HR, 1.336; 95%CI, 0.868-1.172 [P=0.304]) . However, statistical significance did not reach that level of confidence in patients with bowel obstruction at diagnosis (HR, 4.026; 95%CI, 2.617-3.533 [P=0.056]) ; these patients had significantly shorter RFS when compared to the patients who did not have this risk factors and T4 tumors (HR, 0.609; 95%CI, 0.591-0.797 [P=0.021]) , had significantly decreased recurrence rate.
The Aim of this retrospective stud was to estimate the benefit of adjuvant chemotherapy for patients with stage II colon cancer .
Trial Design : include patients with colon cancer stage II who underwent surgery , in the period from January 2010 to December 2015 in Ain Shams university Hospital. patients received adjuvant Chemotherapy were compared to those who had received no treatment .
Results : The study included sixty-seven patients . The mean age for all patients was 57 years. Thirty-nine patients received adjuvant chemotherapy due to being considered as high risk and twenty-eight low risk patients were followed up without treatment . Median follow up time was 16 months . patients who received adjuvant chemotherapy had median Overall survival 53 months vs 49 months in those who did not (P= 0.921) and median Relapse free survival 37 months vs 26 months (P= 0.145) . In terms of Relapse free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Within the adjuvant group, the most frequent poor prognostic features included: suboptimal lymph node sampling 64% ,clinical obstruction or perforation 31% , T4 invasion 23% ,lymphovascular invasion 10% and poor differentiation 5% .
When the effects of the significant Variables on death risk were investigated by multivariate analyses , No statistically significant overall survival differrance could be detected among those variables : Age (HR,0.902; 95%CI, 0.204-4.053 [P=0.906]) Lymphovascular invasion (HR,0.271; 95%CI, 0.176-0.237 [P=0.321]) , suboptimal LN resection (HR, 1.866; 95%CI, 1.213-1.637 [P=0.671] ) . However, Significant survival difference demonstrated in : clinical obstruction at diagnosis (HR, 4.630; 95%CI, 2.750-3.712 [P=0.054]) had significant shorter OS , T4 tumors (HR0.181 95%CI 0.118-0.159 [P=0.041]) had significant improvement of OS and Sidedness ,and patients with right sided colon cancer had a small significant improved overall survival (HR 0.85 95% CI 0.75–0.98, p = 0.033) than left sided patients .
No statistically significant RFS differrance could be detected among those variables : age [HR], 1.00; 95%CI, 0.437-2.536 [P=0.805]), suboptimal LN resection (Hazard Ratio [HR], 0.614; 95%CI, 0.399-0.539 [P=0.658]) and Lympho-vascular invasion( HR, 1.336; 95%CI, 0.868-1.172 [P=0.304]) . However, statistical significance did not reach that level of confidence in patients with bowel obstruction at diagnosis (HR, 4.026; 95%CI, 2.617-3.533 [P=0.056]) ; these patients had significantly shorter RFS when compared to the patients who did not have this risk factors and T4 tumors (HR, 0.609; 95%CI, 0.591-0.797 [P=0.021]) , had significantly decreased recurrence rate.
Other data
| Title | Benefit of adjuvant chemotherapy in patients with stage II colon cancer: A Retrospective study | Other Titles | الاستفادة من العلاج الكيمائي في حالات أورام القولون السرطانية من المرحلة الثانية: دراسة استرجاعية | Authors | Osama Hashem Abdulhameed Abdulazez | Issue Date | 2017 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.