Few population-based analyses on treatment outcomes of colorectal cancer (CRC) have been conducted in Asian countries. We conducted a nationwide study to assess the outcomes of adjuvant chemotherapy (AC) for patients with stage II and III CRC in South Korea.
Data from the Health Insurance Review and Assessment Service Database (HIRA) were analyzed for demographics, tumor characteristics, adjuvant chemotherapy, and survival of patients who underwent curative-intent surgical resection for CRC from 2011 to 2014.
From the HIRA data, a total of 61315 patients were identified: 15620 (25.5%) in stage I, 20525 (33.5%) in Stage II, and 25170 (41.0%) in stage III. Chemotherapy regimens were consisted: 11332 (18.5%) in 5-fluorouraci plus leucovorin or capecitabine (FL/CAP), 13183 (21.5%) in FL/CAP with oxaliplatin (FOLFOX/CAPOX), 357 (0.6%) in uracil and tegafur/doxifluridine (UFT/D) and 36443 (59.4%) in surgery alone. For the patients with stage II colorectal cancer, the adjuvant chemotherapy was associated with a significant increase in survival rate (FL/CAP: hazard ratio [HR], 0.44; 95% CI, 0.40-0.50, and FOLFOX/CAPOX: HR, 0.48; 95% CI, 0.41-0.55, respectively), however UFT/D regimens were not statistically significant. In the patients with stage III, the adjuvant chemotherapy was significantly effective for survival rate (FL/CAP: HR, 0.43; 95% CI, 0.40-0.47, FOLFOX/CAPOX: HR, 0.38; 95% CI, 0.36-0.41, respectively), UFT/D were also not statistically effective.
Adjuvant chemotherapy with FL/CAP and FOLFOX/CAPOX showed a survival benefit for patients with stage II and III colorectal cancer.
Clinical trial identification
Legal entity responsible for the study
In Gyu Hwang
All authors have declared no conflicts of interest.