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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 10/2014

01-10-2014 | Original Article

The role of adjuvant chemotherapy in stage II colorectal cancer patients

Authors: Hung-Hsin Lin, Yu-Yao Chang, Jen-Kou Lin, Jeng-Kai Jiang, Chun-Chi Lin, Yuan-Tzu Lan, Shung-Haur Yang, Huann-Sheng Wang, Wei-Shone Chen, Tzu-Chen Lin, Shih-Ching Chang

Published in: International Journal of Colorectal Disease | Issue 10/2014

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Abstract

Purpose

Adjuvant chemotherapy use in stage II colorectal cancer (CRC) is debated. We evaluated the prognostic significance of clinicopathological features recommended by most guidelines for identifying high-risk stage II CRC and adjuvant chemotherapeutic response.

Methods

We enrolled 1,039 stage II CRC patients who underwent curative surgery at Taipei Veterans General Hospital from January 2005 to December 2010. Seventy-seven patients who received radiotherapy were excluded. The endpoint was disease-free survival.

Results

Of 962 patients, 37 had stage T4 tumors; 50, lymphovascular invasion; 39, poor differentiation; 249, preoperative carcinoembryonic antigen (CEA) levels >5 ng/mL; and 53 underwent emergent operations. One hundred ninety-four patients received 5-fluorouracil-based adjuvant chemotherapy. During a median follow-up period of 60.2 months, recurrence developed in 110 patients (11.4 %). The 5-year disease-free survival (DFS) was 87.6 %. In multivariate analysis, preoperative CEA >5 ng/ml (p = 0.001), emergent operation for obstruction/perforation (p = 0.008), lymphovascular invasion (p = 0.014), and T4 disease (p = 0.030) were significantly associated with poor DFS. High-risk stage II patients (n = 484) benefited from adjuvant chemotherapy (5-year DFS with and without adjuvant chemotherapy, 87.3 vs. 78.9 %; p = 0.028).

Conclusions

Adjuvant chemotherapy improved DFS in high-risk stage II CRC patients, but not in low-risk patients.
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Metadata
Title
The role of adjuvant chemotherapy in stage II colorectal cancer patients
Authors
Hung-Hsin Lin
Yu-Yao Chang
Jen-Kou Lin
Jeng-Kai Jiang
Chun-Chi Lin
Yuan-Tzu Lan
Shung-Haur Yang
Huann-Sheng Wang
Wei-Shone Chen
Tzu-Chen Lin
Shih-Ching Chang
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 10/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-014-1943-6

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