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Retrospective analysis of a Bi‐National Colorectal Cancer Audit to characterize stage II colon cancer patients who were offered adjuvant chemotherapy
Author(s) -
Cooper Edward A.,
Buxey Kenneth N.,
Maslen Ben J.,
Muhlmann Mark
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15735
Subject(s) - medicine , colorectal cancer , adjuvant chemotherapy , stage (stratigraphy) , oncology , cancer , chemotherapy , audit , retrospective cohort study , adjuvant , general surgery , breast cancer , paleontology , management , economics , biology
Background Adjuvant chemotherapy for stage II colon cancer is a controversial area with treatment often reserved for patients with high‐risk clinicopathological features. The aim of this study was to characterize which patients with stage II disease were offered adjuvant chemotherapy in an Australian and New Zealand setting. Methods Data was retrospectively collected from the prospectively maintained Bi‐National Colorectal Cancer Audit. Data from all patients with their first episode of stage II colon cancer from January 2007 to January 2019 were included. Results A total of 3763 patients were identified in the Bi‐National Colorectal Cancer Audit database with stage II colon cancer, of which 715 were offered chemotherapy (19%). Patients were at significant greater odds of being offered chemotherapy for stage II disease if they were <55 years old, from an urban area, discussed in a multidisciplinary team (MDT) meeting, had a greater operative urgency, a lower American Society of Anesthesiologists score, had a T4 tumour or had less than 12 lymph nodes harvested. Conclusion In Australia and New Zealand the appropriate patients with high‐risk features are more likely to be offered chemotherapy in line with current guideline recommendations; however, this may not be the case for regional patients. A large proportion of patients were not discussed at MDT meeting– given the decision to provide adjuvant chemotherapy for stage II disease remains a controversial area, and the likely small survival benefit offered by adjuvant chemotherapy, appropriate patient selection is critical and best discussed in an MDT setting.