Ann Surg Treat Res.  2015 Sep;89(3):124-130. 10.4174/astr.2015.89.3.124.

Oncologic outcomes of early adjuvant chemotherapy initiation in patients with stage III colon cancer

Affiliations
  • 1Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Korea. sgbeak@dsmc.or.kr

Abstract

PURPOSE
Although adjuvant chemotherapy reduces the risk of disease recurrence in stage III colon cancer patients, published guidelines do not specify when it should be initiated. This study aimed to assess the effect of adjuvant chemotherapy initiation time on disease recurrence and survival in stage III colon cancer patients undergoing curative surgical resection.
METHODS
The medical records of stage III colon cancer patients undergoing curative resection between February 2004 and December 2009 were reviewed.
RESULTS
Of the 133 enrolled patients, 27 (20.3%) began adjuvant chemotherapy within 3 weeks of surgery, whereas 106 (79.7%) did after 3 weeks following surgery. Patients receiving chemotherapy within 3 weeks of surgery were less likely to experience recurrences than those beginning treatment later (11.1% vs. 33%, P = 0.018). The mean disease-free survival of patients receiving adjuvant therapy earlier was 54.6 months, whereas that of patients with later treatment was 43.5 months (P = 0.014). However, no significant differences in overall survival were observed between the 2 groups.
CONCLUSION
Adjuvant chemotherapy should be initiated as soon as a patient's clinical condition allows. Patients with stage III colon cancer may benefit from adjuvant chemotherapy initiated within 3 weeks of surgery.

Keyword

Colonic neoplasm; Adjuvant chemotherapy; Prognosis; Survival

MeSH Terms

Chemotherapy, Adjuvant*
Colon*
Colonic Neoplasms*
Disease-Free Survival
Drug Therapy
Humans
Medical Records
Prognosis
Recurrence

Figure

  • Fig. 1 Cumulative recurrence rates of both groups.

  • Fig. 2 Disease-free survival rates of both groups. Group A, patients receiving chemotherapy within 3 weeks of surgery; group B, patients receiving chemotherapy after 3 weeks of surgery.

  • Fig. 3 Overall survival rates of both groups. Group A, patients receiving chemotherapy within 3 weeks of surgery; group B, patients receiving chemotherapy after 3 weeks of surgery.


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