UIC Study Supports Use of Adjuvant Chemotherapy in Stage II Colon Cancer

A retrospective study by researchers at the University of Illinois at Chicago (UIC) has found a correlation between overall survival (OS) and adjuvant chemotherapy in stage II patients with colon cancer. Most importantly, the improved OS was independent of patient age, their risk of disease, or the treatment administered.

As of date, a lot of variability has been observed when treating patients diagnosed with early-stage colon cancer with adjuvant chemotherapy. Particularly in stage II disease, its use varies between patients and institutions. Per current guidelines, discussions on adjuvant chemotherapy are recommended for patients diagnosed with a high-risk stage II disease.

Using data archived in the National Cancer Data Base, clinical and demographic information on 153,110 patients diagnosed with stage II colon cancer between 1998 and 2006 was analyzed. This included demographics, tumor characteristics, management, and survival. Survival information included data gathered until 2011.

According to the results, which were published in Cancer, significant determinants of receiving chemotherapy included:

• Being male
• Age less than 65
• Nonwhite race
• Community clinical setting
• Non-Medicare insurance
• Diagnosis prior to 2004

The most significant finding of the study was that OS not only improved, but was clinically relevant, when patients were treated with adjuvant chemotherapy, independent of their tumor pathology, age, or chemotherapy regimen that was administered. The authors also note that there was no difference in survival between single and multiagent chemotherapy regimens.

“The results of this study are exciting, and certain aspects not entirely expected,” according to lead author Ajay Maker, MD. Maker is associate professor of surgery in the UIC College of Medicine and director of surgical oncology for the Advocate Creticos Cancer Center. “For many years, studies have included, but not focused on, stage 2 colon cancer patients. This study, which looks at the largest group of stage 2 colon cancer patients to date, set out to better understand the role of adjuvant chemotherapy in treating patients that are fighting this specific type and stage of cancer.”

The third most common cancer to be diagnosed irrespective of gender in the United States, colon cancer is the second leading cause of cancer-related deaths in the country, estimated to cause nearly 50,000 deaths in 2016.

“We have to be careful when looking for associations retrospectively,” Maker added. “However, our research validates the need for prospective studies to identify the specific subgroups of stage 2 colon cancer patients who may benefit most from the use of adjuvant chemotherapy.”

Reference

Casadaban L, Rauscher G, Aklilu M, Villenes D, Freels S, Maker AV. Adjuvant chemotherapy is associated with improved survival in patients with stage II colon cancer [published online July 15, 2016]. Cancer. doi:10.1002/cncr.30181.