Original Article
Effect of adjuvant chemotherapy after radical resection on colon cancer prognosis and its relative factors analysis in elderly patients
Qiong Qin, Lin Yang, Yongkun Sun, Jianming Ying, Yan Song, Wen Zhang, Jinwan Wang, Aiping Zhou
Published 2016-03-14
Cite as Chin J Geriatr, 2016, 35(3): 296-300. DOI: 10.3760/cma.j.issn.0254-9026.2016.03.018
Abstract
ObjectiveTo explore the effect of adjuvant chemotherapy on colon cancer prognosis and its prognostic factors in elderly patients with stage Ⅱ/Ⅲ colon cancer after radical resection.
MethodsThe clinical and pathological as well as postoperative therapy data were collected and analyzed in elderly patients (aged>60 years) with stage Ⅱ/Ⅲ colon cancer undergoing radical resection. The disease-free survival (DFS) and overall survival (OS) rate was compared between the surgery-alone group and the postoperative adjuvant chemotherapy group by Kaplan-Meier analysis, and patients were sub-grouped based on clinical stage. The analysis of prognostic factors was conducted by Cox regression.
ResultsAmong 317 patients, 113 patients received surgery alone and 204 patients received postoperative adjuvant chemotherapy (fluorouracil alone or combined with oxaliplatin). There were no significant differences in DFS and OS between the two groups (69.0% vs. 69.6%, 69.9% vs. 76.0%, P=0.966 and 0.250). No difference in DFS and OS in patients with stage Ⅱcolon cancer was observed between the two groups (82.3% vs. 82.1%, 83.5% vs. 88.4%, P=0.959 and 0.306). However, postoperative adjuvant chemotherapy improved DFS and OS in patients with stage Ⅲ colon cancer (38.2% vs. 58.7%, 38.2% vs. 65.1%, P=0.02 and 0.003). Multivariate analysis showed that the independent predictors for prognosis were T4, N+ , combination with vascular invasion, surgery alone, preoperative CA19-9 level.
ConclusionsPostoperative adjuvant chemotherapy cannot improve the DFS and OS in elderly patients with stageⅡcolon cancer, but can improve the overall survival rate in those with stage Ⅲ. TNM staging, vascular invasion, preoperative CA19-9 level and the therapeutic model after surgery are the independent factors influencing the prognosis in elderly patients with colon cancer.
Key words:
Colonic neoplasms; Antienoplastic combined chemotherapy protocols; Prognosis
Contributor Information
Qiong Qin
Medical Oncology Department, General Hospital, Tianjin Medical University, Tianjin 300052, China
Lin Yang
Medical Oncology Department, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100022, China
Yongkun Sun
Medical Oncology Department, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100022, China
Jianming Ying
Pathology Department, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical college, Beijing 100022, China
Yan Song
Medical Oncology Department, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100022, China
Wen Zhang
Medical Oncology Department, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100022, China
Jinwan Wang
Medical Oncology Department, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100022, China
Aiping Zhou
Medical Oncology Department, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100022, China