P-263 - Colon Carcinoma stage II: Chemotherapy or Surveillance?

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Presenter R. Moreira Gomes
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors R. Moreira Gomes1, I. Pimentel2, C. Sarmento1, M. Damasceno1
  • 1Hospital de S. João, Porto/PT
  • 2Centro Hospitalar de S. João, Porto/PT

Abstract

Introduction

Colorectal cancer is the third most common tumour in men and the second in women and is the fourth most common cancer-related cause of death in the world.

The aim of this work is the analysis of the experience of a Portuguese institution in the treatment of stage II colon carcinoma, particularly in the use of adjuvant chemotherapy in high-risk patients.

Methods

Retrospective observational study of 70 patients with stage II colon carcinoma, diagnosed at the Pathology Department between July 2008 and July 2010.

Survival analysis was performed by using the Kaplan-Meier method.

Results

Of the 70 patients 30 were female and 40 male. The median age at diagnosis was 67,91 years [37, 91]. 24 patients were classified as not at high risk and 46 as high-risk, and high risk was defined as stage IIB (pT4N0M0), occlusion or tumor perforation, inadequate lymph node resection (<12 ganglia), or evidence of lymphatic, venous or perineural permeation.

The overall survival (OS) at 5 years was 79,2% and 83,1% in non-high-risk group and 77,1% in high risk.

Of high-risk patients only 37% received chemotherapy, capecitabine monotherapy being the most chosen scheme. There was one relapse in non-high-risk group (4.2%) and 15 in the high-risk group (32.6%). Of the patients who relapsed, 7 were rescued with surgery and / or chemotherapy, currently lying in complete clinical remission. Among the risk factors mentioned above, there was a trend in the OS loss in cases of intestinal occlusion, insufficient lymph node dissection, intravenous and perineural invasion, but only perineural invasion was statistically significant. There was no statistically significant difference in progression-free survival (PFS) or OS of high-risk patients receiving chemotherapy, for those who opted for surveillance.

Conclusion

The use of chemotherapy in patients with high-risk stage II colon carcinoma had no impact on the OS or PFS, and this can be explained by the small sample size and the fact that only 37% of these had been administered chemotherapy.

The decision to submit this subgroup of patients adjuvant chemotherapy should be individualized and discussed with the patient.