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Estimating the Adjuvant Chemotherapy Effect in Elderly Stage II and III Colon Cancer Patients in an Observational Study

Authors
 Ki-Yeol Kim  ;  In-Ho Cha  ;  Joong Bae Ahn  ;  Nam Kyu Kim  ;  Sun Young Rha  ;  Hyun Cheol Chung  ;  Jae Kyung Roh  ;  Sang Joon Shin 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.107(6) : 613-618, 2013 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2013
MeSH
Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use* ; Chemotherapy, Adjuvant ; Colectomy* ; Colonic Neoplasms/drug therapy* ; Colonic Neoplasms/mortality ; Colonic Neoplasms/pathology ; Colonic Neoplasms/surgery ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Matched-Pair Analysis ; Neoplasm Staging ; Propensity Score ; Retrospective Studies ; Survival Analysis ; Treatment Outcome
Keywords
Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use* ; Chemotherapy, Adjuvant ; Colectomy* ; Colonic Neoplasms/drug therapy* ; Colonic Neoplasms/mortality ; Colonic Neoplasms/pathology ; Colonic Neoplasms/surgery ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Matched-Pair Analysis ; Neoplasm Staging ; Propensity Score ; Retrospective Studies ; Survival Analysis ; Treatment Outcome
Abstract
PURPOSE: Adjuvant chemotherapy has been known as a standard treatment for patients with resected colon cancer. However, in elderly colon cancer patients, the characteristics of patients are heterogeneous with regard to life expectancy and comorbidities. Thus, with regard to the effectiveness of adjuvant chemotherapy for colon cancer, it is difficult to extrapolate data of clinical trials from the younger into the older general population. METHODS: Data for 382 elderly colon cancer patients were analyzed: 217 in Stage II and 165 in Stage III. The efficacy of adjuvant chemotherapy was evaluated in elderly colon cancer patients after a match by the propensity score method. RESULTS: For matched patients with Stage II colon cancer, there was no significant efficacy of adjuvant chemotherapy in the risk of death during all follow-up periods (P-value, 0.06-0.37). Though there was a tendency that the adjuvant chemotherapy reduces the death rate during the follow-up periods, it was not statistically significant. In the case of Stage III, the adjuvant chemotherapy was significantly effective in matched patients for 5-year (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.30-0.90) and overall survival (HR, 0.56; 95% CI, 0.34-0.94). CONCLUSIONS: Adjuvant chemotherapy for elderly patients with Stage II colon cancer is not effective, whereas elderly patients with Stage III with adjuvant chemotherapy appear to have a better survival rate in the general population.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.23290/abstract
DOI
10.1002/jso.23290
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Oral Cancer Research Institute (구강종양연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Yeol(김기열) ORCID logo https://orcid.org/0000-0001-5357-1067
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Cha, In Ho(차인호) ORCID logo https://orcid.org/0000-0001-8259-2190
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86851
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