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Colon cancer: survival after curative surgery
K H Link1, T A Sagban, M Mörschel
1Surgical Center, Asklepios Tumor Treatment Center Rhein-Main, Asklepios Paulinen Klinik, Geisenheimerstrasse 10, 65197 Wiesbaden, Germany. k-h.link@asklepios.com
Langenbeck'S Archives of Surgery
|September 30, 2004
Summary
Survival rates for colon cancer vary significantly. Adjuvant chemotherapy improves outcomes for stages IIB and III, and molecular markers like thymidylate synthase may help personalize treatment strategies.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Oncology
- Cancer Genetics
Background:
- Colon cancer survival rates exhibit considerable variation based on UICC stage, treatment modality, and geographical location.
- Factors influencing these survival disparities include surgical techniques, surgeon/hospital volume, and statistical methodologies.
Purpose of the Study:
- To review evolving factors impacting survival in surgically and medically treated colon cancer patients.
- To highlight the role of adjuvant chemotherapy and molecular markers in treatment strategy and patient selection.
Main Methods:
- Review of recent clinical trials and published reports on colon cancer survival.
- Analysis of the impact of adjuvant chemotherapy on survival rates across different UICC stages.
- Exploration of molecular and genetic factors (thymidylate synthase, microsatellite instability) as prognostic indicators.
Main Results:
- Adjuvant chemotherapy improves survival by 5%-12% in UICC stage III and selected UICC stage II patients compared to surgery alone.
- Recent trials show enhanced survival rates with standard adjuvant chemotherapy (e.g., 59% to 71% in stage III and IIB).
- Molecular markers like thymidylate synthase (TS) and microsatellite instability (MSI) may independently influence prognosis and aid in chemotherapy selection.
Conclusions:
- Adjuvant chemotherapy is a crucial component in improving colon cancer survival for specific patient groups.
- Molecular profiling, particularly TS expression, holds promise for optimizing adjuvant chemotherapy selection.
- Understanding these factors is vital for refining treatment strategies and informing patient choices in colon cancer care.