Adjuvant Chemo Provides No Benefit in Stage II Colon Cancer
Chemo not tied to improved overall survival for patients with or without poor prognostic features
FRIDAY, July 29 (HealthDay News) -- For patients with stage II colon cancer with or without poor prognostic features, adjuvant chemotherapy does not improve overall survival, according to a study published online July 25 in the Journal of Clinical Oncology.
Erin S. O'Connor, M.D., from the University of Wisconsin in Madison, and colleagues investigated the overall survival benefit of chemotherapy among patients with stage II colon cancer having poor prognostic features. A total of 43,032 Medicare beneficiaries, from the Surveillance, Epidemiology, and End Results Medicare database, who underwent colectomy for stage II and III primary colon adenocarcinoma, diagnosed from 1992 to 2005, were included in the analysis. Of these, 24,847 patients had stage II colon cancer. Differences in patient and disease-related characteristics were assessed, and five-year overall survival was examined using Kaplan-Meier survival analysis.
The investigators found that 75 percent of the patients with stage II cancer had one or more poor prognostic features. Adjuvant chemotherapy was given to 20 and 57 percent of the patients with stage II and III disease, respectively. After adjustments, only patients with stage III disease showed a significant five-year survival benefit with chemotherapy (hazard ratio, 0.64). No survival benefit was seen among patients with stage II cancer, either with no or any poor prognostic features.
"Among Medicare patients identified with stage II colon cancer, either with or without poor prognostic features, adjuvant chemotherapy did not substantially improve overall survival," the authors write.
One study author disclosed financial ties to the pharmaceutical industry.