Top

International Journal of Colorectal Disease

Published in:

01-12-2024 | Cytostatic Therapy | RESEARCH

Adjuvant chemotherapy decision-making in stage II colon adenocarcinoma associated with patients’ age and high-risk factors

Authors: Pengwen Zheng, Chao Ye, Hui Liu, Xinyi Gao, Hai Huang

Published in: International Journal of Colorectal Disease | Issue 1/2024

Abstract

Purpose

To clarify whether the combination of age and high-risk factors (HRFs) was preferable for adjuvant chemotherapy (AC) decision-making in patients with stage II colon adenocarcinoma.

Methods

We conducted a retrospective study analyzing eligible colon cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2017. A nomogram was used to predict patient prognosis. Decision curve analysis (DCA) predicted model clinical benefit. Restricted cubic spline calculated the optimal cut-off value.

Results

A total of 8570 patients with stage II colon adenocarcinoma were included in this study; 25.2% received AC. A nomogram predicting the prognosis of patients with stage II colon adenocarcinoma was constructed with age and HRFs, and scores were assigned to the relevant variables. DCA showed that age combined with HRFs was superior to treatment decision-making based on HRFs alone. Patients were grouped according to their total score with the cut-off value of 100. AC did not significantly improve overall survival (OS) in low-score group (hazard ratios (HRs) 1.01, 95% confidence intervals (CIs) 0.86–1.18, p = 0.918). In high-score group, AC improved 5-year OS by about 7.6% (HR 0.73, 95% CI 0.61–0.88, p = 0.001). And high-score group mainly included patients aged < 50 years with two or more HRFs and patients aged ≥ 50 years with at least one HRF.

Conclusion

Age and HRFs could be preferable for determining the group of stage II colon adenocarcinoma patients who would benefit from AC. Patients aged < 50 years with two or more HRFs might be a potential benefit population for AC.

Available only for authorised users

Siegel RL, Wagle NS, Cercek A et al (2023) Colorectal cancer statistics, 2023. CA Cancer J Clin 73(3):233–254CrossRefPubMed

Gunderson LL, Jessup JM, Sargent DJ et al (2010) Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol 28(2):264–271CrossRefPubMed

Baxter NN, Kennedy EB, Bergsland E et al (2022) Adjuvant therapy for stage II colon cancer: ASCO Guideline Update. J Clin Oncol 40(8):892–910CrossRefPubMed

O’Connor ES, Greenblatt DY, LoConte NK et al (2011) Adjuvant chemotherapy for stage II colon cancer with poor prognostic features. J Clin Oncol 29(25):3381–3388CrossRefPubMedPubMedCentral

Kumar A, Kennecke HF, Renouf DJ et al (2015) Adjuvant chemotherapy use and outcomes of patients with high-risk versus low-risk stage II colon cancer. Cancer 121(4):527–534CrossRefPubMed

Verhoeff SR, van Erning FN, Lemmens VEPP et al (2016) Adjuvant chemotherapy is not associated with improved survival for all high-risk factors in stage II colon cancer. Int J Cancer 139(1):187–193CrossRefPubMed

Hajirawala LN, Yi Y, Herritt BC et al (2022) Multiple high-risk features for stage II colon carcinoma portends worse survival than stage III disease. Dis Colon Rectum 66(8):1076–1084CrossRefPubMed

Argilés G, Tabernero J, Labianca R et al (2020) Localised colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 31(10):1291–1305CrossRefPubMed

Babcock BD, Aljehani MA, Jabo B et al (2018) High-risk stage II colon cancer: not all risks are created equal. Ann Surg Oncol 25(7):1980–1985CrossRefPubMed

10.

Hagerty BL, Aversa JG, Dominguez DA et al (2022) Age determines adjuvant chemotherapy use in resected stage II colon cancer. Dis Colon Rectum 65(10):1206–1214CrossRefPubMedPubMedCentral

11.

Kneuertz PJ, Chang GJ, Hu CY et al (2015) Overtreatment of young adults with colon cancer. JAMA Surg 150(5)

12.

Adamo M, Groves C, Dickie L et al (2023) SEER program coding and staging manual 2023. In: U.S. Department of Health and Human Services National Institutes of Health National Cancer Institute. https://seer.cancer.gov/tools/codingmanuals/

13.

Birkett RT, Chamely E, Concors SJ et al (2019) Overuse and limited benefit of chemotherapy for stage II colon cancer in young patients. Clin Colorectal Cancer 18(4):292–300CrossRefPubMed

14.

Yang L, Chen X, Lee C et al (2023) Functional characterization of age-dependent p16 epimutation reveals biological drivers and therapeutic targets for colorectal cancer. J Exp Clin Cancer Res 42(1)

15.

Turrell FK, Orha R, Guppy NJ et al (2023) Age-associated microenvironmental changes highlight the role of PDGF-C in ER+ breast cancer metastatic relapse. Nat Cancer 4(4):468–484CrossRefPubMedPubMedCentral

16.

Zahed H, Feng X, Sheikh M et al (2023) Age at diagnosis for lung, colon, breast and prostate cancers: An international comparative study. Int J Cancer 154(1):28–40CrossRefPubMed

17.

Han S, Georgiev P, Ringel AE et al (2023) Age-associated remodeling of T cell immunity and metabolism. Cell Metab 35(1):36–55CrossRefPubMed

18.

Network NCC. NCCN Clinical practice guidelines in oncology (NCCN Guidelines^®) Colon Cancer Version 1.2023. https://www.nccn.org/

19.

Liu LL, Xiang ZL (2022) Adjuvant chemotherapy improves survival in high-risk stage II colon cancer: a retrospective cohort study. Therap Adv Gastroenterol 15

20.

Ginesi MC, Bliggenstorfer JT, Kwesiga DM et al (2023) Factors associated with receipt of adjuvant chemotherapy in stage II colon cancer. Ann Surg Oncol. https://doi.org/10.1245/s10434-023-13631-zCrossRefPubMed

21.

Tie J, Cohen JD, Lahouel K et al (2022) Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer. N Engl J Med 386(24):2261–2272CrossRefPubMedPubMedCentral

22.

Boeken T, Blons H, Dean C et al (2023) The potential of ctDNA in locoregional therapies for colorectal cancer. Lancet Gastroenterol Hepatol 8(12):1072–1073CrossRefPubMed

23.

Schøler LV, Reinert T, Ørntoft M-BW et al (2017) Clinical implications of monitoring circulating tumor DNA in patients with colorectal cancer. Clin Cancer Res 23(18):5437–5445

24.

Loft M, To YH, Gibbs P et al (2023) Clinical application of circulating tumour DNA in colorectal cancer. Lancet Gastroenterol Hepatol 8(9):837–852CrossRefPubMed

Title: Adjuvant chemotherapy decision-making in stage II colon adenocarcinoma associated with patients’ age and high-risk factors
Authors: Pengwen Zheng
Chao Ye
Hui Liu
Xinyi Gao
Hai Huang
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Cytostatic Therapy
Colon Cancer
Colon Cancer
Published in: International Journal of Colorectal Disease / Issue 1/2024
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-023-04581-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Adjuvant chemotherapy decision-making in stage II colon adenocarcinoma associated with patients’ age and high-risk factors

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

The effect of nurse assisted colonoscopy on adenoma detection rates: A meta-analysis of randomized controlled trials

Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study

Correlations between preoperative statin treatment with short- and long-term survival following colorectal cancer surgery: a propensity score-matched national cohort study

Correction to: Robotic colorectal resection in combination with a multimodal enhanced recovery program - results of the first 100 cases

Efficacy of electroacupuncture therapy in patients with functional anorectal pain: study protocol for a multicenter randomized controlled trial

Prediction of 30-day, 90-day, and 1-year mortality after colorectal cancer surgery using a data-driven approach