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International Journal of Colorectal Disease

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Open Access 01-08-2019 | Metastasis | Original Article

The prognostic effect of adjuvant chemotherapy in the colon cancer patients with solitary lymph node metastasis

Authors: Seung-Seop Yeom, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim, Young Jin Kim

Published in: International Journal of Colorectal Disease | Issue 8/2019

Abstract

Purpose

Previous studies have reported paradoxical survival prognoses for some node-negative and node-positive colon cancer patients. However, current guidelines recommend adjuvant chemotherapy (CT) only for node-positive patients. This study investigated the efficacy of adjuvant CT for patients who underwent radical surgery for colon cancer with solitary lymph node (LN) metastasis.

Methods

This study included 281 patients treated between 2004 and 2015. Patients were classified into no-CT (n = 39) and CT (n = 242) groups, and the survival outcomes and recurrence-related follow-up data were analyzed.

Results

The groups exhibited similarities in tumor sidedness, tumor differentiation, and pathologic stage. However, the age, ASA class, and preoperative CEA level were relatively lower in the CT group. Although the CT group had a higher 5-year overall survival (OS) rate than the no-CT group (88.4% vs. 65.3%, p < 0.001), the groups did not differ in terms of 5-year disease-free survival (DFS) (CT, 84.1% vs. no-CT, 83.3%, p = 0.490). A multivariate analysis identified adjuvant CT as an independent factor for OS but not for DFS. A highly examined LN count (≥ 12) was associated with improved DFS improvement. However, D3 LN dissection was not associated with DFS or OS. For DFS, intermediate/apical positive LNs received a high hazard ratio relative to pericolic/epicolic LNs (2.080, 95% confidence interval: 0.979–4.416), but this was not significant (p = 0.057).

Conclusions

Adjuvant chemotherapy did not provide clear advantages for colon cancer with solitary LN metastasis. Further large studies that analyze several prognostic factors are needed to establish tailored adjuvant CT administration guidelines.

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Title: The prognostic effect of adjuvant chemotherapy in the colon cancer patients with solitary lymph node metastasis
Authors: Seung-Seop Yeom
Soo Young Lee
Chang Hyun Kim
Hyeong Rok Kim
Young Jin Kim
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Cytostatic Therapy
Colon Cancer
Colon Cancer
Published in: International Journal of Colorectal Disease / Issue 8/2019
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-019-03346-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The prognostic effect of adjuvant chemotherapy in the colon cancer patients with solitary lymph node metastasis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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