Association between Timing and Duration of Adjuvant Chemotherapy and Colorectal Cancer Survival in Korea, 2011-2014: A Nationwide Study based on the Health Insurance Review and Assessment Service Databaseopen access
- Authors
- Choi, Jin Hwa; Lee, Ji Sung; Baek, Sun Kyung; Kim, Jong Gwang; Kim, Tae Won; Sohn, Seung Kook; Kang, Mi Yeon; Lee, Sang-Cheol; Hwang, In Gyu
- Issue Date
- Jan-2022
- Publisher
- Ivyspring International Publisher
- Keywords
- colorectal cancer; adjuvant chemotherapy; timing; duration
- Citation
- Journal of Cancer, v.13, no.8, pp 2440 - 2446
- Pages
- 7
- Journal Title
- Journal of Cancer
- Volume
- 13
- Number
- 8
- Start Page
- 2440
- End Page
- 2446
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21081
- DOI
- 10.7150/jca.71141
- ISSN
- 1837-9664
- Abstract
- Background: Population-based analyses of the treatment outcomes of colorectal cancer (CRC) in Asian countries are limited. Therefore, we conducted a nationwide study to assess the relationship between the timing and duration of adjuvant chemotherapy (AC) and survival in patients with CRC in South Korea. Methods: Data on AC from the Health Insurance Review and Assessment Service Database (HIRA) were analyzed, and the survival of patients who underwent curative-intent surgical resection for CRC between 2011 and 2014 was investigated. Results: From the HIRA data, 45,992 patients with stage II-III CRC were identified. Chemotherapy regimens were administered as follows: 10,640 (23.3%) received 5-fluorouracil and leucovorin/capecitabine (FL/CAP), 13,083 (28.7%) received FUCAP plus oxaliplatin (FOLFOX/CAPDX), 299 (0.7%) received uracil and tegafur/doxifluridine (UFT/D), and 21,570 (47.3%) underwent surgery alone. Patients who did not receive AC had worse survival than those who received AC in both the colon and rectum groups (HR, 1.96, 95% CI, 1.85-2.07 and HR, 2.18, 95% CI, 2.01-2.37, respectively). Regarding patients with stage II-III CRC, AC initiation >= 2 months after surgery was associated with a significant decrease in overall survival (OS) (FUCAP: HR, 1.82; 95% CI, 1.53-2.17 and FOLFOX/CAPDX: HR, 2.92; 95% CI, 2.47-3.45); however, the effects of UFT/D regimens were not statistically significant. For patients with stage II-III colon cancer, AC <3 months had lower OS (FL/CAP: HR, 3.72, 95% CI, 2.80-4.94; FOLFOX/CAPDX: HR, 2.15, 95% CI, 1.87-2.47; and UFT/D: HR, 1.74, 95% CI, 0.56-5.41). In terms of patients with stage II-III rectal cancer, AC <3 months, regardless of chemotherapy regimens, had a significant lower survival (FUCAP: HR, 1.91, 95% CI, 1.66-2.20; FOLFOX/CAPDX: HR, 2.20, 95% CI, 1.75-2.77; and UFT/D: HR, 3.71, 95% CI, 1.45-9.44). Conclusions: Postoperative time to initiation and duration of AC were associated with survival. Based on our results, initiating AC within 2 months after surgery and administering AC for >3 months can potentially have an OS benefit in patients with stage II-III CRC.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.