This study investigated the effect of oxaliplatin-containing adjuvant chemotherapy according to the distribution of lymph node (LN) metastases for patients with stage III colon cancer (CC).
Among 1554 patients with CRC who underwent surgical resection between 2010 and 2014, 254 patients were diagnosed with stage III CC, and adjuvant chemotherapy was administered. Patients were treated with either oxaliplatin-containing chemotherapy or non-oxaliplatin-containing chemotherapy according to each investigator decision. LN distribution was classified on the basis of the Japanese classification of colorectal carcinoma. The patients were grouped into two categories: pericolic LN-positive and extrapericolic LN-positive.
Among the 254 patients enrolled in this study, 175 belonged to the PLN group, whereas the remaining 79 patients to the ELN group. The PLN group was also divided into two groups based on the regimen: 79 patients were included in the non-oxaliplatin-containing chemotherapy group, while 96 in the oxaliplatin-containing chemotherapy group. The characteristics were similar between two groups, except for age and body mass index. During the median follow-up duration of 48.5 months (range 4.7-94.0), 39 (15.4%) patients died and 47 (30.5%) patients experienced recurrence and the estimated DFS and OS at 3 years was 82.8% and 90.1%, respectively. In the univariate analysis, oxaliplatin chemotherapy was not significantly associated with DFS (p = 0.457) and OS (p = 0.147). In the multivariate analysis, the addition of oxaliplatin showed no prognostic significance on DFS (p = 0.073) and OS (p = 0.594).
In conclusion, oxaliplatin-containing adjuvant chemotherapy was not found to have a significant effect on survival for stage III CC patients with only PLN. Accordingly, the current study can provide a novel strategy for subgroups with limited LNs distribution, considering that the state of the LN distribution is a critical factor for therapeutic success.
Clinical trial identification
Legal entity responsible for the study
Jong Gwang Kim.
Has not received any funding.
All authors have declared no conflicts of interest.