CRC: adjuvant chemotherapy prolongs survival in stage IV disease

  • Nozawa H & al.
  • Ther Adv Med Oncol
  • 1 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Adjuvant chemotherapy (ACT)—typically 6 months of oral 5-FU (+ folinate), oral/infusional 5-FU, and oxaliplatin—was associated with greater recurrence-free survival (RFS) and OS after curative surgery in patients with stage IV colorectal cancer (CRC).

Why this matters

  • ACT has shown benefit in stage III disease but few studies have been performed in stage IV CRC.

Study design

  • Retrospective analysis (n=155).
  • Median follow-up time was 54.3 months.
  • Funding: Japan Society for the promotion of Science, Project for Cancer Research and Therapeutic Evolution.

Key results

  • AC was administered to 57% of patients who underwent surgery between 2003-2010, and 76% between 2011 and 2017 (P=.015).
  • 51 patients received 5-FU (and folinate), 30 mFOLFOX6, 15 oxaliplatin/capecitabine, and 7 oxaliplatin/S-1.
  • After propensity-score matching, ACT was associated with improved 2-year (28% vs 19%) and 5-year RFS (25% vs 16%; P<.001>
  • 2- and 5-year OS were likewise improved (88% vs 76%; 66% vs 46%; P=.0008).
  • In multivariate analysis, ACT predicted improved RFS (HR=1.86; P=.003) and OS (HR=2.66; P=.002).
  • ACT was associated with improved RFS in patients with regional lymph node metastases (HR, 2.03; P<.0001 and those with no nodal involvement p=".029).</li">

    Limitations

    • Retrospective study.
    • Small sample size.
    • Japanese population.
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