Adjuvant Chemotherapy Duration and Disease-Free Survival in Low-Risk Stage III Colon Cancer with N1a-b and N1c Disease: Insights from a Single-Center Retrospective Analysis.
Humans
Chemotherapy, Adjuvant
/ methods
Colonic Neoplasms
/ mortality
Female
Retrospective Studies
Male
Middle Aged
Neoplasm Staging
Aged
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Disease-Free Survival
Fluorouracil
/ therapeutic use
Leucovorin
/ therapeutic use
Adult
Prognosis
Organoplatinum Compounds
/ therapeutic use
Adjuvant
Chemotherapy
Colon cancer
Tumor deposit
Journal
Journal of gastrointestinal cancer
ISSN: 1941-6636
Titre abrégé: J Gastrointest Cancer
Pays: United States
ID NLM: 101479627
Informations de publication
Date de publication:
31 Oct 2024
31 Oct 2024
Historique:
accepted:
27
10
2024
medline:
1
11
2024
pubmed:
1
11
2024
entrez:
31
10
2024
Statut:
epublish
Résumé
Tumor deposits (TDs) are known to have a poor prognosis independent of lymph node (LN) involvement and are considered equivalent to LN metastases in the latest staging system. In stage III colon cancer (CC), high-risk patients (pT4 or pN2) receive 6 months of adjuvant chemotherapy, while low-risk patients (pT1-3 and N1) are recommended either 3 or 6 months of CAPOX or 6 months of FOLFOX therapy. However, the optimal chemotherapy duration for low-risk patients classified as pN1c remains unknown. The aim of this study is to investigate the impact of adjuvant chemotherapy duration (3 months vs. 6 months) on survival in patients with low-risk stage III CC either in pN1a-b and pN1c patient groups. We retrospectively analyzed patients with stage III CC who underwent surgery at a tertiary center between January 2014 and May 2024. Demographic and pathological data of patients were retrospectively collected. The primary outcome was disease-free survival (DFS). A total of 142 patients were included. Among the patients, 116 were pT1-3N1a-b and 26 were pT1-3N1c. Local (23.1% vs. 1.7%, P < 0.001) and overall (38.5% vs 14.6%, P = 0.011) recurrences were significantly higher in the pN1c group. Univariate and multivariate analyses revealed no significant impact of adjuvant chemotherapy duration on DFS in the pN1a-b group (P = 0.359), whereas in the pN1c group, 3-month chemotherapy resulted in significantly shorter DFS (P = 0.044) in univariate analysis. Our study indicates that shorter duration of adjuvant chemotherapy is associated with worse survival and 6-month chemotherapy is recommended for patients with pT1-3 and N1c disease.
Sections du résumé
BACKGROUND
BACKGROUND
Tumor deposits (TDs) are known to have a poor prognosis independent of lymph node (LN) involvement and are considered equivalent to LN metastases in the latest staging system. In stage III colon cancer (CC), high-risk patients (pT4 or pN2) receive 6 months of adjuvant chemotherapy, while low-risk patients (pT1-3 and N1) are recommended either 3 or 6 months of CAPOX or 6 months of FOLFOX therapy. However, the optimal chemotherapy duration for low-risk patients classified as pN1c remains unknown. The aim of this study is to investigate the impact of adjuvant chemotherapy duration (3 months vs. 6 months) on survival in patients with low-risk stage III CC either in pN1a-b and pN1c patient groups.
METHODS
METHODS
We retrospectively analyzed patients with stage III CC who underwent surgery at a tertiary center between January 2014 and May 2024. Demographic and pathological data of patients were retrospectively collected. The primary outcome was disease-free survival (DFS).
RESULTS
RESULTS
A total of 142 patients were included. Among the patients, 116 were pT1-3N1a-b and 26 were pT1-3N1c. Local (23.1% vs. 1.7%, P < 0.001) and overall (38.5% vs 14.6%, P = 0.011) recurrences were significantly higher in the pN1c group. Univariate and multivariate analyses revealed no significant impact of adjuvant chemotherapy duration on DFS in the pN1a-b group (P = 0.359), whereas in the pN1c group, 3-month chemotherapy resulted in significantly shorter DFS (P = 0.044) in univariate analysis.
CONCLUSION
CONCLUSIONS
Our study indicates that shorter duration of adjuvant chemotherapy is associated with worse survival and 6-month chemotherapy is recommended for patients with pT1-3 and N1c disease.
Identifiants
pubmed: 39480587
doi: 10.1007/s12029-024-01135-2
pii: 10.1007/s12029-024-01135-2
doi:
Substances chimiques
Fluorouracil
U3P01618RT
Leucovorin
Q573I9DVLP
Organoplatinum Compounds
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
14Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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