Jeong Woon Kyung, Shin Je-Wook, Baek Seong Kyu
Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Korea.
Ann Surg Treat Res. 2015 Sep;89(3):124-30. doi: 10.4174/astr.2015.89.3.124. Epub 2015 Aug 24.
Although adjuvant chemotherapy reduces the risk of disease recurrence in stage III colon cancer patients, published guidelines do not specify when it should be initiated. This study aimed to assess the effect of adjuvant chemotherapy initiation time on disease recurrence and survival in stage III colon cancer patients undergoing curative surgical resection.
The medical records of stage III colon cancer patients undergoing curative resection between February 2004 and December 2009 were reviewed.
Of the 133 enrolled patients, 27 (20.3%) began adjuvant chemotherapy within 3 weeks of surgery, whereas 106 (79.7%) did after 3 weeks following surgery. Patients receiving chemotherapy within 3 weeks of surgery were less likely to experience recurrences than those beginning treatment later (11.1% vs. 33%, P = 0.018). The mean disease-free survival of patients receiving adjuvant therapy earlier was 54.6 months, whereas that of patients with later treatment was 43.5 months (P = 0.014). However, no significant differences in overall survival were observed between the 2 groups.
Adjuvant chemotherapy should be initiated as soon as a patient's clinical condition allows. Patients with stage III colon cancer may benefit from adjuvant chemotherapy initiated within 3 weeks of surgery.
尽管辅助化疗可降低III期结肠癌患者疾病复发的风险，但已发表的指南并未明确应何时开始化疗。本研究旨在评估辅助化疗开始时间对接受根治性手术切除的III期结肠癌患者疾病复发及生存的影响。
回顾性分析2004年2月至2009年12月期间接受根治性切除的III期结肠癌患者的病历。
在133例入组患者中，27例（20.3%）在术后3周内开始辅助化疗，而106例（79.7%）在术后3周后开始化疗。术后3周内接受化疗的患者比开始治疗较晚的患者复发可能性更低（11.1%对33%，P = 0.018）。较早接受辅助治疗的患者无病生存期平均为54.6个月，而较晚接受治疗的患者为43.5个月（P = 0.014）。然而，两组间总生存期无显著差异。
只要患者临床情况允许，应尽早开始辅助化疗。III期结肠癌患者可能从术后3周内开始的辅助化疗中获益。
