Adjuvant chemotherapy for patients with stage II high-risk and III colon cancer: Hindering factors to adherence and impact on long-term survival

Jieun Kim; Ri Na Yoo; Hyeon-Min Cho; Bong-Hyeon Kye; Hyung Jin Kim

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자료유형: 학술저널

저자정보: Jieun Kim (The Catholic University of Korea) Ri Na Yoo (The Catholic University of Korea) Hyeon-Min Cho (The Catholic University of Korea) Bong-Hyeon Kye (The Catholic University of Korea) Hyung Jin Kim (The Catholic University of Korea)

저널정보: 대한종양외과학회 KOREAN JOURNAL OF CLINICAL ONCOLOGY Korean Journal of Clinical Oncology 제17권 제1호

발행연도: 2021.6

수록면: 8 - 14 (7page)

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Purpose: Adjuvant chemotherapy is recommended after curative surgery in patients with colon cancer of high-risk stage II and stage III. However, a considerable number of patients cannot complete the scheduled adjuvant treatment for various reasons. This study investigates the hindering factors to the adherence to adjuvant chemotherapy and their impact on long-term survival.
Methods: A retrospective study was conducted for patients with colon cancer and had curative resection from 2009 to 2014. Among patients with pathologic stage II and III, stage II with low-risk features, double primary cancers, R2 resection cases were excluded. Patients were grouped into three groups: no-adjuvant therapy, adjuvant therapy for less than 3 months, and more than 3 months. Factors for withdrawal and the oncologic outcome were analyzed.
Results: Of 571 patients, adjuvant chemotherapy was recommended in 403. One hundred and sixteen patients (28.8%) did not receive adjuvant chemotherapy, 78 (19.4%) withdrew within 3 months, and 209 (51.9%) maintained for more than 3 months. Factors for not receiving adjuvant chemotherapy or withdrawing within 3 months were older than 70 and American Society of Anesthesiologists class 3 or higher. Main reasons for discontinuation before 3 months were chemotoxicity and patient’s refusal. The long-term oncologic outcome of the patients who received adjuvant chemotherapy for more than 3 months was significantly better than others.
Conclusion: No-adjuvant therapy or receiving them for lesser than 3 months is significantly affected by the patient’s performance status and social support, which coincides with a poor oncologic outcome. Social support and rehabilitation system may help to improve the survival outcome.

#Adjuvant chemotherapy #Colon neoplasms #Adherence

참고문헌 (19)

참고문헌 신청

Benson AB 3rd / 2017 / Colon cancer, version 1. 2017, NCCN clinical practice guidelines in oncology / J Natl Compr Canc Netw 15:370~398

Kuebler JP / 2007 / Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer : results from NSABP C-07 / J Clin Oncol 25:2198~2204

Andre T / 2009 / Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial / J Clin Oncol 27:3109~3116

Yothers G / 2011 / Oxaliplatin as adjuvant therapy for colon cancer : updated results of NSABP C-07 trial, including survival and subset analyses / J Clin Oncol 29:3768~3774

Zhao H / 2018 / Adherence to treatment guidelines and survival for older patients with stage II or III colon cancer in Texas from 2001 through 2011 / Cancer 124:679~687

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