Takeaway
- An analysis of the Surveillance, Epidemiology, and End Results (SEER) database shows no survival benefit, and some potential harm, with adjuvant chemotherapy (ACT) for stage II colon cancer.
Why this matters
- The authors argue that the ACT real-world benefit is much lower than previously believed, and that colon-cancer-specific death (CCSD) should replace OS as a primary endpoint in clinical trials.
Study design
- Propensity-score matching and retrospective analyses of the SEER database (n=58,133).
- Funding: Various Chinese government sources.
Key results
- 25.66% of patients received ACT.
- Overall CCSD rate was 19.95%, and non-CCSD rate was 25.78%.
- ACT was associated with more CCSD (HR, 1.23; P<.001 and less non-ccsd p>
- Findings were confirmed in propensity-score matched analysis of 13,806 pairs (HR, 1.16 and HR, 0.60, both P<.001>
Limitations
- Retrospective analysis.
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