Prognostic impact of interhospital variation in adjuvant chemotherapy for patients with Stage II/III colorectal cancer: a nationwide study

2018 ◽  
Vol 20 (7) ◽  
pp. O162-O172 ◽  
Author(s):  
K. Arakawa ◽  
K. Kawai ◽  
T. Tanaka ◽  
K. Hata ◽  
K. Sugihara ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Prognostic Impact ◽  
Nationwide Study

Association between timing and duration of adjuvant chemotherapy and survival for colorectal cancer in korea, 2011-2014: A nationwide study based on the database of quality assessment and the health insurance.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3605-3605 ◽  
Author(s):  
In Gyu Hwang ◽  
Ji Sung Lee ◽  
Sang-Cheol Lee ◽  
Sun Kyung Baek ◽  
Jong Gwang Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Health Insurance ◽  
Adjuvant Chemotherapy ◽  
Population Based ◽  
Stage Ii ◽  
Curative Intent ◽  
Nationwide Study ◽  
Time To Initiation ◽  
Overall Survival Benefit

3605 Background: Few population-based analyses on treatment outcomes of colorectal cancer (CRC) have been conducted in Asian countries. We conducted a nationwide study to assess relationship between timing and duration of adjuvant chemotherapy (AC) and survival for patients with CRC in South Korea. Methods: Data from the Health Insurance Review and Assessment Service Database (HIRA) were analyzed for demographics, tumor characteristics, adjuvant chemotherapy, and survival of patients who underwent curative-intent surgical resection for CRC from 2011 to 2014. Results: From the HIRA data, a total of 61315 patients were identified: 15620 (25.5%) in stage I, 20525 (33.5%) in Stage II, and 25170 (41.0%) in stage III. Chemotherapy regimens were consisted: 11332 (18.5%) in 5-fluorouracil and leucovorin/capecitabine (FL/CAP), 13183 (21.5%) in FL/CAP plus oxaliplatin (FOLFOX/CAPOX), 357 (0.6%) in uracil and tegafur/doxifluridine (UFT/D) and 36443 (59.4%) in surgery alone. For patients with stage II and III CRC, the initiation of AC ≥ 8 weeks after surgery was associated with a significant decrease in overall survival (OS) (FL/CAP: HR, 1.82; 95% CI, 1.53 to 2.17, and FOLFOX/CAPOX: HR, 2.92; 2.47 to 3.45, respectively), however UFT/D regimens were not statistically significant. For patients with stage II and III colon cancer, receiving AC < 3 months had lower OS (FL/CAP: HR, 3.72; 95% CI, 2.80 to 4.94, FOLFOX/CAPOX: HR, 2.15; 1.87 to 2.47, and UFT/D: HR, 1.74; 0.56 to 5.41, respectively). For patients with stage II and III rectal cancer, receiving AC < 3 months regardless of chemotherapy regimens had a significant lower survival (FL/CAP: HR, 1.91; 1.66 to 2.20, FOLFOX/CAPOX: HR, 2.20; 1.75 to 2.77, and UFT/D: HR, 3.71; 1.45 to 9.44, respectively). Conclusions: Time to initiation and duration of AC after surgery were associated with survival. Based on our results, starting within 8 weeks and receiving more than 3 months of AC are needed to have an overall survival benefit.

scholarly journals Predictive and Prognostic Effects of Primary Tumor Size on Colorectal Cancer Survival

2021 ◽  
Vol 11 ◽  
Author(s):  
Olatunji B. Alese ◽  
Wei Zhou ◽  
Renjian Jiang ◽  
Katerina Zakka ◽  
Zhonglu Huang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Primary Tumor ◽  
Cox Proportional Hazards ◽  
Stage Ii ◽  
Stage Iii ◽  
Resection Margins ◽  
Prognostic Impact ◽  
Primary Tumor Size

BackgroundPathologic staging is crucial in colorectal cancer (CRC). Unlike the majority of solid tumors, the current staging model does not use tumor size as a criterion. We evaluated the predictive and prognostic impact of primary tumor size on all stages of CRC.MethodsUsing the National Cancer Database (NCDB), we conducted an analysis of CRC patients diagnosed between 2010 and 2015 who underwent resection of their primary cancer. Univariate and multivariate analyses were used to identify predictive and prognostic factors, Kaplan-Meier analysis and Cox proportional hazards models for association between tumor size and survival.ResultsAbout 61,000 patients met the inclusion criteria. Median age was 63 years and majority of the tumors were colon primary (82.7%). AJCC stage distribution was: I - 20.1%; II - 32.1%; III - 34.7% and IV - 13.1%. The prognostic impact of tumor size was strongly associated with survival in stage III disease. Compared to patients with tumors &lt;2cm; those with 2-5cm (HR 1.33; 1.19-1.49; p&lt;0.001), 5-10cm (HR 1.51 (1.34-1.70; p&lt;0.001) and &gt;10cm (HR 1.95 (1.65-2.31; p&lt;0.001) had worse survival independent of other variables. Stage II treated without adjuvant chemotherapy had comparable survival outcomes (HR 1.09; 0.97-1.523; p=0.148) with stage III patients who did, while Stage II patients who received adjuvant chemotherapy did much better than both groups (HR 0.76; 0.67-0.86; p&lt;0.001). Stage III patients who did not receive adjuvant chemotherapy had the worst outcomes among the non-metastatic disease subgroups (HR 2.66; 2.48-2.86; p&lt;0.001). Larger tumors were associated with advanced stage, MSI high, non-rectal primary and positive resection margins.ConclusionsFurther studies are needed to clarify the role of tumor size in prognostic staging models, and how to incorporate it into therapy decisions.

The efficacy of adjuvant chemotherapy for resected high-risk stage II and stage III colorectal cancer in frail patients

2021 ◽  
Author(s):  
Kosuke Mima ◽  
Nobutomo Miyanari ◽  
Keisuke Kosumi ◽  
Takuya Tajiri ◽  
Kosuke Kanemitsu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Stage Iii ◽  
Frail Patients
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