Effectiveness of Adjuvant Chemotherapy with 5-FU/Leucovorin and Prognosis in Stage II Colon Cancer.
10.3393/jksc.2011.27.6.322
- Author:
Sun Hee JEE
1
;
Sun Mi MOON
;
Ui Sup SHIN
;
Hoe Min YANG
;
Dae Yong HWANG
Author Information
1. Department of Surgery, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea. msm386@yahoo.co.kr
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Colon cancer;
Adjuvant chemotherapy;
Survival;
Prognosis
- MeSH:
Chemotherapy, Adjuvant;
Colon;
Colonic Neoplasms;
Disease-Free Survival;
Fluorouracil;
Follow-Up Studies;
Humans;
Leucovorin;
Lymph Nodes;
Multivariate Analysis;
Prognosis;
Recurrence
- From:Journal of the Korean Society of Coloproctology
2011;27(6):322-328
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aims of this study were to investigate the survival results and the prognostic factors of adjuvant chemotherapy in stage II colon cancer in the sparsity of Korean data. METHODS: From 1993 to 2006, 363 curatively resected pathologic stage II colon cancer patients were enrolled. Six cycles of adjuvant chemotherapy was performed: intravenous bolus 5-fluorouracil (5-FU) 500 mg/m2 with leucovorin 20 mg/m2 for 2 hours daily for 5 days, followed by a 3-week resting period (n = 308). Fifty-five patients received only curative surgery. A high risk of recurrence was defined as the presence of one or more of the following factors: T4 tumor, lympho-vascular invasion, perineural invasion, perforation, obstruction, retrieved lymph node < 12, and poorly differention. The median follow-up period was 68 months (1 to 205 months). RESULTS: The five-year overall survival (OS) rate was 90.1%, and the five-year disease-free survival (DFS) rate was 84.7%. Among high-risk patients, the OS and the DFS rates of the treatment group were significantly higher than those of the non-treatment group (OS: 90.6% vs. 69.1%, P < 0.0001; DFS: 85.9% vs. 54.1%, P < 0.0001). Among low-risk patients, the survival results of the treatment group were also significantly superior (OS: 97.7% vs. 88.2%, P < 0.0001; DFS: 93.0% vs. 80.0%, P = 0.001). In the multivariate analysis, adjuvant chemotherapy was a significantly favorable prognostic factor for overall survival (hazard ratio, 0.41; 95% confidence interval, 0.22 to 0.75; P = 0.004). CONCLUSION: In our population, adjuvant chemotherapy showed superior survival to curative surgery alone and significantly reduced the risk of death. A nationwide multicenter randomized trial is needed.
