Irinotecan and oxaliplatin might provide equal benefit as adjuvant chemotherapy for patients with resectable synchronous colon cancer and liver-confined metastases: A nationwide database study
Journal
Anticancer Research
Journal Volume
37
Journal Issue
12
Date Issued
2017-01-01
Author(s)
Abstract
© 2017 International Institute of Anticancer Research. All rights reserved. Background: Although irinotecan and oxaliplatin are both standard treatments for advanced colon cancer, it remains unknown whether either is effective for patients with resectable synchronous colon cancer and liver-confined metastasis (SCCLM) after curative surgery. Patients and Methods: A population-based cohort of patients diagnosed with de novo SCCLM between 2004 and 2009 was established by searching the database of the Taiwan Cancer Registry and the National Health Insurance Research Database of Taiwan. Patients who underwent curative surgery as their first therapy followed by chemotherapy doublets were classified into the irinotecan group or oxaliplatin group accordingly. Patients who received radiotherapy or did not receive chemotherapy doublets were excluded. Results: We included 6,533 patients with de novo stage IV colon cancer. Three hundred and nine of them received chemotherapy doublets after surgery; 77 patients received irinotecan and 232 patients received oxaliplatin as adjuvant chemotherapy. The patients in both groups exhibited similar overall survival (median: not reached vs. 40.8 months, p=0.151) and time to the next line of treatment (median: 16.5 vs. 14.3 months, p=0.349) in both univariate and multivariate analyses. Additionally, patients with resectable SCCLM had significantly shorter median overall survival than patients with stage III colon cancer who underwent curative surgery and subsequent adjuvant chemotherapy, but longer median overall survival than patients with de novo stage IV colon cancer who underwent surgery only at the primary site followed by standard systemic chemotherapy (p<0.001). Conclusion: Irinotecan and oxaliplatin exhibited similar efficacy in patients who underwent curative surgery for resectable SCCLM.
Subjects
Chemotherapy | Colon cancer | Irinotecan | Oxaliplatin | Prognosis | Resectable | Synchronous liver-confined metastases
Chemotherapy; Colon cancer; Irinotecan; Oxaliplatin; Prognosis; Resectable; Synchronous liver-confined metastases
SDGs
Other Subjects
bevacizumab; cetuximab; fluorouracil; irinotecan; oxaliplatin; antineoplastic agent; camptothecin; irinotecan; oxaliplatin; platinum complex; adjuvant chemotherapy; adult; aged; Article; cancer chemotherapy; cancer survival; cohort analysis; colon cancer; female; human; liver metastasis; major clinical study; male; overall survival; priority journal; retrospective study; treatment duration; adjuvant chemotherapy; analogs and derivatives; cancer staging; colon tumor; factual database; Kaplan Meier method; liver tumor; middle aged; multivariate analysis; outcome assessment; pathology; procedures; proportional hazards model; secondary; statistics and numerical data; Taiwan; Aged; Antineoplastic Agents; Camptothecin; Chemotherapy, Adjuvant; Colonic Neoplasms; Databases, Factual; Female; Humans; Kaplan-Meier Estimate; Liver Neoplasms; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; Organoplatinum Compounds; Outcome Assessment (Health Care); Proportional Hazards Models; Retrospective Studies; Taiwan
Type
journal article