Hormoz MAHMOUDVAND, Abdolhassan TALAEIZADEH, Hojatallah SHAHBAZIAN, Khatereh ANBARI, Sareh JAHANBAKHSH, Sedigheh NADRI

Investigation of the effect of adjuvant chemotherapy in stage II colorectal cancers

Colorectal cancer is the most prevalent and malignant gastrointestinal cancer and the fourth most common cancer around the world. Selection of the treatment method is based on the staging of the disease. The aim of this interventional study is to investigate the effect of adjuvant chemotherapy on local recurrence, distant metastases, and three-year disease-free lifespan in patients with stage II colorectal cancer. This study conducted between 2001 and 2007 involved 40 patients with stage II colorectal cancer. Subsequent to surgery, the adjuvant chemotherapy was performed employing the FOLFOX4 diet therapy; the patients were further examined every 3 months using tumor marker counts, sonography, CT scan and colonoscopy for identification of any local recurrence and metastasis. Finally, at the end of the third year and after chemotherapy, the rates of local recurrence, metastasis and survival of the patients were investigated. The present study was conducted on 40 patients, 23 of whom were male and the rest were female. After three years of follow-up, 2 patients had local recurrence and 7 patients had distant metastasis. All of the patients survived throughout the three-year follow-up period. In this study, the adjuvant chemotherapy in stage II colorectal cancer led to significant overall survival and three-year diseasefree survival.

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Mekata E, Sonoda H , Shimizu T, Tatsuta T, Yamaguchi T, Endo Y, Tani T. Clinical predictive value of in vitro anticancer drug sensitivity test for the therapeutic effect of adjuvant chemotherapy in patients with stage II-III colorectal cancer. Mol Clin Oncol 2013; 1: 763-7.

Benson AB, Schrag D, Somerfield MR. American Society of Clinical Oncology recommendations on adjuvant chemotherapy for Stage II cancer. J Clin Oncol 2004; 22: 340819.

Gray RG, Barnwell J, Hills R, McConkey C, Williams N, Kerr D. QUASAR: a randomized study of chemotherapy (CT) vs observation including 3238 colorectal cancer patients. Proc Am Soc Clin Oncol 2004; 22: 3501-6.

Sakamoto JL, Hamada C, Kodaira S, Nakazato H, Ohashi Y. Adjuvant therapy with oral fluoropyrimidines after curative resection for colorectal cancer: Individual patient data metaanalysis of randomized trials. Jpn J Clin Oncol 1999; 29:78-86

Gill SL, Loprinzi CL, Sargent DJ, Thomé SD, Alberts SR, Haller DG, Benedetti J, Francini G, Shepherd LE, Francois Seitz J, Labianca R, Chen W, Cha SS, Heldebrant MP, Goldberg RM.. Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer; who benefits and by how much? J Clin Oncol 2004; 22: 1797-1806.

Mamounas EL, Wieand S, Wolmark N, Bear HD, Atkins JN, Song K, Jones J, Rockette H. 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 (C-01, C-02, C-03, C-04). J Clin Oncol 1999; 17:1349-55.

Johnston PG. Stage II Colorectal Cancer: To Treat or not to Treat. Oncologist 2005; 10:332-4.

Park YJL, Park KJ, Park JG, Lee KU, Choe KJ, Kim JP. Prognostic factors in 2230 Korean colorectal cancer patients: Analysis of consecutively operated cases. World J Surg 1999; 23:721- 6.

Mahmoudvand H, Forutani S, Nadri S. Comparison of Treatment Outcomes of Surgical Repair in Inguinal Hernia with Classic versus Preperitoneal Methods on Reduction of Postoperative Complications. Biomed Res Int 2017;2017:3785302.

Bittorf B, Merkel S, Merkel U, Matzel KE, Wein A, Dimmler A, Hohenberger W. Primary Signet-Ring cell carcinoma of the colorectum. Langenbeck’s Arch Sur 2004; 389:178-83

Gatta G, Ciccolallo L, Capocaccia R, Coleman MP, Hakulinen T, Møller H, Berrino F; EUROCARE Working Group. Differences in colorectal cancer survival between Europe and U.S. populations: The importance of sub-site and morphology. Eur J Cancer 2003; 39: 2214-22.

McLeish JAL, Thursfield VJ, Giles GG. Survival from colorectal cancer in Victoria: 10-Year follow-up of the 1987 management survey. ANZ J Surg 2002; 72:352-6.

Hermosillo-Rodriguez JL, Anaya DA, Sada Y, Walder A, Amspoker AB, Berger DH, Naik AD. The effect of age and comorbidity on patient-centered health outcomes in patients receiving adjuvant chemotherapy for colon cancer. Eur J Cancer 2003; 39:2214-22.

Lieffers JR, Baracos VE, Winget M, Fassbender K. A comparison of Charlson and Elixhauser comorbidity measures to predict colorectal survival using administrative health data. Cancer 2011; 117: 1957-65.

Edge S, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC Cancer Staging Manual 2011; 45-81. New York.

Zwierzina H. Adjuvant therapy of stage II colorectal cancer – who will benefit from treatment? Memo-magazine of Eur Med Oncol 2008; 1:75-7.

Andre T, Boni C, Mounedji-Boudiaf L, Navarro M, Tabernero J, Hickish T, Topham C, Zaninelli M, Clingan P, Bridgewater J, Tabah-Fisch I, de Gramont A; Multicenter International Study of Oxaliplatin/5-Fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer (MOSAIC) Investigators. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 2004; 23: 2343-51.

Xu Z, Mohile SG, Tejani MA, Becerra AZ, Probst CP, Aquina CT, Hensley BJ, Arsalanizadeh R, Noyes K, Monson JR, Fleming FJ. Poor compliance with adjuvant chemotherapy use associated with poorer survival in patients with rectal cancer: An NCDB analysis. Cancer 2017; 123:52-61.

Kuan FC, Lai CH, Ku HY, Wu CF, Hsieh MC, Liu TW, Yeh CY, Lee KD. The survival impact of delayed surgery and adjuvant chemotherapy on stage II/III rectal cancer with pathological complete response after neoadjuvant chemoradiation. Int J Cancer 2017; 140: 1662-9.

Wilkinson N. Surgical therapy for colorectal adenocarcinoma. Gastroenterol Clin North 2008; 37: 253-67.

McCleary NJ, Benson AB, Dienstmann R. Personalizing Adjuvant Therapy for Stage II/III Colorectal Cancer. Am Soc Clin Oncol Educ Book 2017; 37: 232-45.