Resultados de la quimioterapia adyuvante en cáncer de colon

Abstract

Background: Adjuvant chemotherapy improves overall and disease free survival in patients with colon cancer subjected to curative surgery. Aim: To assess the effects of chemotherapy on the survival of patients with colon cancer. Material and Methods: All patients operated for a colon cancer stage II or III are included. The clinical and pathological features, relapse and survival of patients receiving chemotherapy and patients treated exclusively with surgical excision, are compared. Results: Two hundred and seventy patients, 168 in stage II and 102 in stage III, were studied. Ninety two (28 in stage II and 64 in stage III), received adjuvant chemotherapy. Patients that received chemotherapy were significantly younger and had significantly better preoperative nutritional status. During a mean follow up of 67 months, among patients in stage II, two of 28 with chemotherapy and five of 140 without chemotherapy, relapsed and died (p = NS). Among patients in stage III, a relapse was observed in nine of 64 patients (14%) in chemotherapy and 13 of 38 patients without chemotherapy (34%, p = 0.02). In this same stage, 6 patients with and 10 patients without chemotherapy, died (9 and 26% respectively, p = 0.07). In a multivariate analysis, more than three involved lymph nodes and chemotherapy had a significant and independent impact on survival, with odds ratios of 4.8 (95% confidence intervals (CI) of 1.5-15.9) and 5.4 (95% CI 1.5-19.2), respectively. Conclusions: Adjuvant chemotherapy improves survival of patients with stage III colon cancer. Among patients in stage II, chemotherapy does not influence survival.