Background/Objectives: This study aimed to assess the efficacy of adjuvant chemotherapy for T1-2 stage III colorectal cancer, a disease with a low recurrence rate.Methods: The efficacies of fluorouracil-based adjuvant chemotherapy (5FU group) and oxaliplatin-based adjuvant chemotherapy (L-OHP group) were assessed and compared with that of surgery alone (surgery group) using data from seven clinical trials conducted by the Japanese Foundation for Multidisciplinary Treatment of Cancer. Propensity score matching was used to compare the three groups. Direct-adjusted survival curves were delineated with consideration of treatment periods.Results: A total of 604 patients with T1-2 stage III colorectal cancer were identified. After adjusting for the patient factors, the hazard ratio of relapse-free survival (RFS) was 0.79 (95% confidence interval (CI): 0.13–4.65,p= 0.79) and 0.64 (95% CI: 0.06–6.40,p= 0.70) in the 5FU and L-OHP groups, respectively. Adjusted 5-year RFS rate was 82.8% (95% CI: 67.2–100%), 86.2% (95% CI: 74.2–100%), and 88.6% (95% CI: 74.0–100%) in the surgery, 5-FU, and L-OHP groups, respectively. Overall and disease-specific survival showed similar trends without significant differences.Conclusions: No significant improvement in prognosis was observed after adjuvant chemotherapy. The potential improvement in the 5-year RFS after adjuvant chemotherapy for resected T1-2 stage III colorectal cancer should be balanced with patient factors and adverse events.
背景/目的：本研究旨在评估辅助化疗对复发率较低的T1-2期III期结直肠癌的疗效。方法：利用日本癌症多学科治疗基金会开展的七项临床试验数据，评估基于氟尿嘧啶的辅助化疗（5FU组）和基于奥沙利铂的辅助化疗（L-OHP组）的疗效，并与单纯手术组（手术组）进行比较。采用倾向评分匹配法对三组进行比较，并考虑治疗周期绘制直接校正生存曲线。结果：共纳入604例T1-2期III期结直肠癌患者。校正患者因素后，5FU组和L-OHP组的无复发生存风险比分别为0.79（95%置信区间：0.13–4.65，p=0.79）和0.64（95%置信区间：0.06–6.40，p=0.70）。手术组、5-FU组和L-OHP组校正后的5年无复发生存率分别为82.8%（95% CI：67.2–100%）、86.2%（95% CI：74.2–100%）和88.6%（95% CI：74.0–100%）。总生存期和疾病特异性生存期呈现相似趋势，均无显著差异。结论：辅助化疗后未观察到预后有显著改善。对于已切除的T1-2期III期结直肠癌，辅助化疗后5年无复发生存率的潜在改善需与患者个体因素及不良反应进行综合权衡。
Efficacy of Adjuvant Chemotherapy for T1-2 Stage III Colorectal Cancer
肿瘤(癌症)患者之家