Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Eur J Cancer. 2016 Aug;63:110-7. doi: 10.1016/j.ejca.2016.04.017. Epub 2016 Jun 11.
The aim of the present EURECCA international comparison is to compare adjuvant chemotherapy and relative survival of patients with stage II colon cancer between European countries.
Population-based national cohort data (2004-2009) from the Netherlands (NL), Denmark (DK), Sweden (SE), England (ENG), Ireland (IE), and Belgium (BE) were obtained, as well as single-centre data from Lithuania. All surgically treated patients with stage II colon cancer were included. The proportion of patients receiving adjuvant chemotherapy was calculated and compared between countries. Besides, relative survival was calculated and compared between countries.
Overall, 59,154 patients were included. The proportion of patients receiving adjuvant chemotherapy ranged from 7.1% to 29.0% (p < 0.001). Compared with NL, a better adjusted relative survival was observed in SE (stage II: relative excess risks (RER) 0.53, 95% confidence interval (CI) 0.44-0.64; p < 0.001), and BE (stage II: RER 0.84, 95% CI 0.76-0.92; p < 0.001), and in IE for patients with stage IIA disease (RER 0.80, 95% CI 0.65-0.98; p = 0.03).
The proportion of patients with stage II colon cancer receiving adjuvant chemotherapy varied largely between seven European countries. No clear linear pattern between adjuvant chemotherapy and adjusted relative survival was observed. Compared with NL, SE and BE showed an improved adjusted relative survival for stage II disease, and IE for patients with stage IIA disease only. Further research into selection criteria for adjuvant chemotherapy could eventually lead to individually tailored, optimal treatment of patients with stage II colon cancer.
本项 EURECCA 国际比较旨在比较欧洲各国 II 期结肠癌患者的辅助化疗与相对生存率。
获取了荷兰（NL）、丹麦（DK）、瑞典（SE）、英格兰（ENG）、爱尔兰（IE）和比利时（BE）的基于人群的国家队列数据（2004-2009 年），以及立陶宛的单中心数据。纳入所有接受 II 期结肠癌手术治疗的患者。计算各国接受辅助化疗的患者比例并进行比较。此外，还计算了各国之间的相对生存率并进行比较。
共纳入 59154 例患者。接受辅助化疗的患者比例为 7.1%-29.0%（p<0.001）。与 NL 相比，SE（II 期：相对超额风险（RER）0.53，95%置信区间（CI）0.44-0.64；p<0.001）和 BE（II 期：RER 0.84，95%CI 0.76-0.92；p<0.001）的调整后相对生存率更好，IE 中 IIA 期疾病患者的调整后相对生存率也更好（RER 0.80，95%CI 0.65-0.98；p=0.03）。
七个欧洲国家中，接受 II 期结肠癌辅助化疗的患者比例差异很大。辅助化疗与调整后相对生存率之间没有明显的线性关系。与 NL 相比，SE 和 BE 的 II 期疾病调整后相对生存率更高，IE 中仅 IIA 期疾病患者的调整后相对生存率更高。进一步研究辅助化疗的选择标准最终可能会为 II 期结肠癌患者提供个体化、最佳的治疗方案。
