Cargando…

Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting

BACKGROUND: Adjuvant chemotherapy (AC) is known to be beneficial for stage III colorectal cancer (CRC). In contrast, only a few studies have reported the survival benefits of AC for stage IV CRC after curative surgery. METHODS: We identified 155 CRC patients with various organ metastases who underwe...

Descripción completa

Detalles Bibliográficos
Autores principales: Nozawa, Hiroaki, Takiyama, Hirotoshi, Hasegawa, Kiyoshi, Kawai, Kazushige, Hata, Keisuke, Tanaka, Toshiaki, Nishikawa, Takeshi, Sasaki, Kazuhito, Kaneko, Manabu, Murono, Koji, Emoto, Shigenobu, Sonoda, Hirofumi, Nakajima, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469283/
https://www.ncbi.nlm.nih.gov/pubmed/31019569
http://dx.doi.org/10.1177/1758835919838960
_version_ 1783411615974031360
author Nozawa, Hiroaki
Takiyama, Hirotoshi
Hasegawa, Kiyoshi
Kawai, Kazushige
Hata, Keisuke
Tanaka, Toshiaki
Nishikawa, Takeshi
Sasaki, Kazuhito
Kaneko, Manabu
Murono, Koji
Emoto, Shigenobu
Sonoda, Hirofumi
Nakajima, Jun
author_facet Nozawa, Hiroaki
Takiyama, Hirotoshi
Hasegawa, Kiyoshi
Kawai, Kazushige
Hata, Keisuke
Tanaka, Toshiaki
Nishikawa, Takeshi
Sasaki, Kazuhito
Kaneko, Manabu
Murono, Koji
Emoto, Shigenobu
Sonoda, Hirofumi
Nakajima, Jun
author_sort Nozawa, Hiroaki
collection PubMed
description BACKGROUND: Adjuvant chemotherapy (AC) is known to be beneficial for stage III colorectal cancer (CRC). In contrast, only a few studies have reported the survival benefits of AC for stage IV CRC after curative surgery. METHODS: We identified 155 CRC patients with various organ metastases who underwent curative surgery in our hospital between 2003 and 2017. Clinicopathological parameters and postoperative AC were reviewed. Multivariate analyses were performed to identify prognostic factors. Moreover, the effects of AC on recurrence-free survival (RFS) and overall survival (OS) were analyzed using inverse probability of treatment weighting. RESULTS: The cohort comprised 94 males and 61 females, with a mean age of 63 years. AC was administered to 57% of patients who underwent surgery between 2003 and 2010 and 76% between 2011 and 2017 (p = 0.015). AC was more likely administered to patients with a good performance status, high preoperative albumin level, regional node and peritoneal metastases, and no intraoperative blood transfusion. Multivariate analyses identified AC as a significant prognostic factors for RFS and OS [hazard ratio (HR): 1.86, p = 0.003, and 2.66, p = 0.002, respectively]. After adjusting for different backgrounds, 5-year RFS and OS rates were higher in patients receiving AC (27% and 67%) than in those without AC (14% and 46%, p < 0.0001 and p = 0.0005). Subgroup analyses showed that AC significantly improved RFS in node-negative patients (HR: 2.16, p = 0.029), and RFS and OS in node-positive patients (HR: 2.03, p < 0.0001, and 2.02, p = 0.001, respectively). CONCLUSION: AC can be discussed with resectable stage IV CRC patients because of its significant survival-improving effects.
format Online
Article
Text
id pubmed-6469283
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-64692832019-04-24 Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting Nozawa, Hiroaki Takiyama, Hirotoshi Hasegawa, Kiyoshi Kawai, Kazushige Hata, Keisuke Tanaka, Toshiaki Nishikawa, Takeshi Sasaki, Kazuhito Kaneko, Manabu Murono, Koji Emoto, Shigenobu Sonoda, Hirofumi Nakajima, Jun Ther Adv Med Oncol Original Research BACKGROUND: Adjuvant chemotherapy (AC) is known to be beneficial for stage III colorectal cancer (CRC). In contrast, only a few studies have reported the survival benefits of AC for stage IV CRC after curative surgery. METHODS: We identified 155 CRC patients with various organ metastases who underwent curative surgery in our hospital between 2003 and 2017. Clinicopathological parameters and postoperative AC were reviewed. Multivariate analyses were performed to identify prognostic factors. Moreover, the effects of AC on recurrence-free survival (RFS) and overall survival (OS) were analyzed using inverse probability of treatment weighting. RESULTS: The cohort comprised 94 males and 61 females, with a mean age of 63 years. AC was administered to 57% of patients who underwent surgery between 2003 and 2010 and 76% between 2011 and 2017 (p = 0.015). AC was more likely administered to patients with a good performance status, high preoperative albumin level, regional node and peritoneal metastases, and no intraoperative blood transfusion. Multivariate analyses identified AC as a significant prognostic factors for RFS and OS [hazard ratio (HR): 1.86, p = 0.003, and 2.66, p = 0.002, respectively]. After adjusting for different backgrounds, 5-year RFS and OS rates were higher in patients receiving AC (27% and 67%) than in those without AC (14% and 46%, p < 0.0001 and p = 0.0005). Subgroup analyses showed that AC significantly improved RFS in node-negative patients (HR: 2.16, p = 0.029), and RFS and OS in node-positive patients (HR: 2.03, p < 0.0001, and 2.02, p = 0.001, respectively). CONCLUSION: AC can be discussed with resectable stage IV CRC patients because of its significant survival-improving effects. SAGE Publications 2019-04-16 /pmc/articles/PMC6469283/ /pubmed/31019569 http://dx.doi.org/10.1177/1758835919838960 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Nozawa, Hiroaki
Takiyama, Hirotoshi
Hasegawa, Kiyoshi
Kawai, Kazushige
Hata, Keisuke
Tanaka, Toshiaki
Nishikawa, Takeshi
Sasaki, Kazuhito
Kaneko, Manabu
Murono, Koji
Emoto, Shigenobu
Sonoda, Hirofumi
Nakajima, Jun
Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting
title Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting
title_full Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting
title_fullStr Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting
title_full_unstemmed Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting
title_short Adjuvant chemotherapy improves prognosis of resectable stage IV colorectal cancer: a comparative study using inverse probability of treatment weighting
title_sort adjuvant chemotherapy improves prognosis of resectable stage iv colorectal cancer: a comparative study using inverse probability of treatment weighting
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469283/
https://www.ncbi.nlm.nih.gov/pubmed/31019569
http://dx.doi.org/10.1177/1758835919838960
work_keys_str_mv AT nozawahiroaki adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT takiyamahirotoshi adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT hasegawakiyoshi adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT kawaikazushige adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT hatakeisuke adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT tanakatoshiaki adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT nishikawatakeshi adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT sasakikazuhito adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT kanekomanabu adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT muronokoji adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT emotoshigenobu adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT sonodahirofumi adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting
AT nakajimajun adjuvantchemotherapyimprovesprognosisofresectablestageivcolorectalcanceracomparativestudyusinginverseprobabilityoftreatmentweighting