Comparison of Clinical and Pathologic Outcomes and Between Patients With Stage II Colon Cancer Who Did And Did Not Receive Postoperative Adjuvant Chemotherapy

Öz

The aim of this study is to compare clinical and pathologic outcomes and survival between patients with stage II colon cancer who did and did not receive postoperative adjuvant chemotherapy. A retrospective examination was made of the records of patients with stage II colon cancer who underwent surgery and followed up in our clinic. Patients were compared with regards to several clinicopathological features such as age, sex, tumor size and stage, number of nodes retrieved, the presence of lymphovascular invasion,  tumor localization, signs of intestinal perforation or obstruction at presentation, disease-free and overall survival rates. A total of 57 patients with stage II colon cancer were included in the study. Overall 43 (%75, 4) patients received postoperative adjuvant chemotherapy and the remainder [n=14 (%24,6)] underwent curative surgery alone. Of the patients with a diagnosis of T4 lesion (n=26), 23 (%53, 5) received postoperative adjuvant chemotherapy. The presence of T4 lesion was found to be significantly associated with recurrence (p: 0.015) but not with overall survival (p: 0, 89). Neither the clinical nor the pathologic features of patients who received chemotherapy were significantly associated with survival or recurrence. Patients  with stage II colon cancer should be treated with the treatment of individual characteristics.

Anahtar Kelimeler

• Stage II colon cancer

Cerrahi Tedavi Sonrası Adjuvan Kemoterapi Alan ve Almayan Evre II Kolon Kanserli Hastaların Klinik ve Patolojik Özelliklerinin Karşılaştırılması

Öz

Bu çalışmanın amacı, evre II kolon kanseri nedeniyle postoperatif adjuvan kemoterapi alan ve almayan hastalar arasındaki klinik ve patolojik özellikleri ve sağkalımı karşılaştırmaktır. Evre II kolon kanseri nedeniyle opere edilen ve kliniğimizde takip edilen hastaların kayıtları retrospektif olarak incelendi. Hastalar yaş, cinsiyet, tümör boyutu ve evresi, alınan lenf nodu sayısı, lenfovasküler invazyon varlığı, tümör lokalizasyonu, tanı sırasındaki bağırsak perforasyonu veya obstrüksiyon bulguları, hastalıksız ve genel sağkalım oranları gibi çeşitli klinikopatolojik özellikler bakımından karşılaştırıldı. Evre II kolon kanseri olan toplam 57 hasta çalışma kapsamına alındı. Toplam 43 (% 75,4) hastaya ameliyat sonrası adjuvan kemoterapi, kalan 14 hastaya (% 24,6) sadece küratif cerrahi uygulandı. .  T4 lezyonlu (n = 26) hastaların 23'ünde (% 53,5) postoperatif adjuvan kemoterapi uygulandı. T4 lezyon varlığının rekürrens üzerine etkisi istatiksel olarak anlamlı bulundu (p = 0.015).Ancak genel sağkalıma etkisi saptanmadı (p = 0.89). Kemoterapi alan hastaların klinik veya patolojik özellikleri, sağkalım veya rekürrens ile anlamlı şekilde ilişkili bulunmamıştır. . Evre II kolon kanserli hastaların tedavi alıp almamasına bireysel özelliklerin değerlendirilmesiyle karar verilmelidir.

Anahtar Kelimeler

• Evre II Kolon Kanser,Postoperatif adjuvan kemoterapi

Kaynakça

1. Referans 1- Jemal A, Siegel R, Ward E, Murray T, Smigal C, Thun MJ, et.al. Cancer statistic.CA Cancer J Clin 2007;57:43-66
2. Referans 2- Nauta R, Stablein DM, Holyoke ED. Survival of patients with stage B2 colon carcinoma. The Gastrointestinal Tumor Study Group experience. Arch Surg 1989; 124:180-182.
3. Referans 3- Engstrom PF, Benson AB 3 rd, Saltz L.Colon Cancer Clinical Practice Guidelines in Oncology. JNCCN 2003;140-153
4. Referans 4- De Dosso S,Sessa C, Saletti P. Adjuvant therapy for colon cancer: present and perspectives. Cancer Treat Rev. 2009; 35: 160-166.
5. Referans 5- Carrato A. Adjuvant treatment of colorectal cancer. Gastrointest Cancer Res. 2008; 2(4 Suppl): 42-46.
6. Referans 6- Figueredo A, Coombes ME, Mukherjee S. Adjuvant therapy for completely resected stage II colon cancer. Cochrane Database Syst Rev. 2008
7. Referans 7- Quah MH, Chou JF, Gönen M, Jinru Shia. Identification of Patients with High Risk Stage II Colon Cancer for Adjuvant Therapy. Dis Colon Rectum 2008; 51: 503-507.
8. Referans 8- Gill S, Loprinzi CL, Sargent DJ, et al. Pooled analysis of fluoroyracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much? J Clin Oncol 2004; 22:1773-1775.

9. Referans 9- Benson AB, Schrag D, Somerfield MR, et al. American Society of Clinical Oncology reccommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol 2004; 22: 3408-3419
10. Referans 10- Mamounas E, Wieand S, Wolmark N, et al. Comparative efficacy of adjuvant chemotherapy in patients with Dukes’ B versus Dukes’ C colon cancer: results from four National Surgical Adjuvant Breast and Bowel Project adjuvant studies. J Clin Oncol 1999; 17: 1349-1355