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Adjuvant Chemotherapy for Stage II Colon Cancer: Practice Patterns and Effectiveness in the General Population
1Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada; Department of Oncology, Queen's University, Kingston, Ontario, Canada; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
Adjuvant chemotherapy (ACT) for stage II colon cancer, even in high-risk cases, did not improve survival. ACT use varied significantly by age and region in this study.
Area of Science:
- Oncology
- Clinical Research
- Cancer Epidemiology
Background:
- Adjuvant chemotherapy (ACT) is not routinely recommended for stage II colon cancer.
- However, ACT may be considered for high-risk stage II disease.
- Practice patterns and outcomes for ACT in stage II colon cancer are not well-defined.
Purpose of the Study:
- To describe practice patterns of ACT in stage II colon cancer.
- To evaluate the association between ACT and survival in stage II colon cancer.
- To assess outcomes for high-risk stage II colon cancer patients receiving ACT.
Main Methods:
- Utilized the Ontario Cancer Registry (2002-2008) linked to electronic treatment records.
- Defined high-risk stage II colon cancer by T4 tumors, <12 lymph nodes, poor differentiation, or lymphovascular invasion.
- Employed modified Poisson and Cox proportional hazards models to analyze ACT association with outcomes.
Main Results:
- 18% of 2488 stage II colon cancer patients received ACT; 24% of 1175 high-risk patients received ACT.
- ACT rates varied by age (higher in younger patients) and geographic region.
- ACT was not associated with improved cancer-specific survival or overall survival in stage II colon cancer, including high-risk cases.
Conclusions:
- Adjuvant chemotherapy use in stage II colon cancer varies significantly by patient age and geographic location.
- Current evidence suggests ACT does not improve survival for stage II colon cancer patients, even those with high-risk disease.
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