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KMID : 1141920210370050298
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Annals of Coloproctology
2021 Volume.37 No. 5 p.298 ~ p.305
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Effect of Adjuvant Chemotherapy on Elderly Stage II High-Risk Colorectal Cancer Patients
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Lee Yu-Jin
Park In-Seok
Cho Hyun-Jin
Gwak Geum-Hee
Yang Keun-Ho
Bae Byung-Noe
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Abstract
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Purpose: Adjuvant chemotherapy (AC) is recommended for patients with stage II colorectal cancer with adverse features. However, the effect of adjuvant treatment in elderly patients with high-risk stage II colorectal cancer remains controversial. This study aimed to investigate the oncologic outcomes in elderly high-risk stage II colorectal cancer patients who underwent curative resection with or without AC.
Methods: Patients aged over 70 years having stage II colorectal adenocarcinoma with at least 1 adverse feature who underwent radical surgery between 2008 and 2017 at a single center were included. We compared recurrence-free survival (RFS) and overall survival (OS) between patients who received more than 80% of the planned AC cycle (the AC+ group) and those who did not receive it (the AC? group).
Results: The AC+ and AC? group contained 46 patients and 50 patients, respectively. The log-rank test revealed no significant intergroup differences in RFS (P=0.083) and OS (P=0.122). In the subgroup of 27 patients with more than 2 adverse features, the AC+ group (n=16) showed better RFS (P=0.006) and OS (P=0.025) than the AC? group. In this subgroup, AC was the only significant factor affecting RFS in the multivariate analysis (P=0.023). AC was significantly associated with OS (P=0.033) in the univariate analysis, but not in the multivariate analysis (P=0.332).
Conclusion: Among elderly patients with stage II high-risk colorectal cancer, the AC+ group did not show better RFS or OS than the AC? group. However, selected patients with more than 2 adverse features might benefit from AC.
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KEYWORD
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Adjuvant chemotherapy, Aged, Colonic neoplasms, Risk factors, Survival analysis
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