PURPOSE: This study was undertaken to examine five possible prognostic factors in patients with recurrent stage II and III colon cancer: time from randomization on an adjuvant therapy clinical trial to tumor recurrence (< 1 year, 1 to 2 years, 2 to 3 years, 3 to 4 years, > 4 years), initial stage (II v III), initial adjuvant treatment (fluorouracil [FU]-based v surgery alone), the era in which the patient entered an adjuvant therapy clinical trial (1978 to 1985, 1986 to 1992, 1993 to 1999), and patient age at recurrence. METHODS: The Adjuvant Colon Cancer End Points (ACCENT) data set was analyzed using univariate and multivariate Cox proportional hazards models, stratified by study. RESULTS: 5,722 (32.9%) of 17,381 patients experienced recurrence. Median survival following recurrence was 13.3 months. Time from randomization to recurrence was highly prognostic of survival following recurrence (P < .0001). Longer survival following recurrence was seen in patients with initial stage II versus III disease (P < .0001; 14.3% 6-year overall survival after recurrence in initial stage II patients), patients entered more recently onto trials (P < .0001), and patients initially treated with surgery alone versus FU adjuvant treatment (P = .0005). All relationships were maintained in multivariate models. CONCLUSION: Time from initial treatment to recurrence and initial stage are important prognostic factors in patients with recurrent colon cancer. Survival following recurrence increased modestly from 1978 to 1999. Patients who had a recurrence following adjuvant therapy had poorer prognosis than those who progressed after surgery alone. These prognostic factors may be useful for clinical trial design and treatment decisions in patients with recurrent colon cancer.
RCT Entities:
PURPOSE: This study was undertaken to examine five possible prognostic factors in patients with recurrent stage II and III colon cancer: time from randomization on an adjuvant therapy clinical trial to tumor recurrence (< 1 year, 1 to 2 years, 2 to 3 years, 3 to 4 years, > 4 years), initial stage (II v III), initial adjuvant treatment (fluorouracil [FU]-based v surgery alone), the era in which the patient entered an adjuvant therapy clinical trial (1978 to 1985, 1986 to 1992, 1993 to 1999), and patient age at recurrence. METHODS: The Adjuvant Colon Cancer End Points (ACCENT) data set was analyzed using univariate and multivariate Cox proportional hazards models, stratified by study. RESULTS: 5,722 (32.9%) of 17,381 patients experienced recurrence. Median survival following recurrence was 13.3 months. Time from randomization to recurrence was highly prognostic of survival following recurrence (P < .0001). Longer survival following recurrence was seen in patients with initial stage II versus III disease (P < .0001; 14.3% 6-year overall survival after recurrence in initial stage II patients), patients entered more recently onto trials (P < .0001), and patients initially treated with surgery alone versus FU adjuvant treatment (P = .0005). All relationships were maintained in multivariate models. CONCLUSION: Time from initial treatment to recurrence and initial stage are important prognostic factors in patients with recurrent colon cancer. Survival following recurrence increased modestly from 1978 to 1999. Patients who had a recurrence following adjuvant therapy had poorer prognosis than those who progressed after surgery alone. These prognostic factors may be useful for clinical trial design and treatment decisions in patients with recurrent colon cancer.
Authors: Osama E Rahma; Mauricio Burotto; Luisa Matos Do Canto; Alexandre A Germanos; Bassem R Haddad; John L Marshall Journal: World J Gastrointest Oncol Date: 2013-11-15
Authors: Stefan Harmsen; Stephan Rogalla; Ruimin Huang; Massimiliano Spaliviero; Volker Neuschmelting; Yoku Hayakawa; Yoomi Lee; Yagnesh Tailor; Ricardo Toledo-Crow; Jeon Woong Kang; Jason M Samii; Hazem Karabeber; Ryan M Davis; Julie R White; Matt van de Rijn; Sanjiv S Gambhir; Christopher H Contag; Timothy C Wang; Moritz F Kircher Journal: ACS Nano Date: 2019-02-04 Impact factor: 15.881
Authors: Aimery de Gramont; Joleen Hubbard; Qian Shi; Michael J O'Connell; Marc Buyse; Jacqueline Benedetti; Brian Bot; Chris O'Callaghan; Greg Yothers; Richard M Goldberg; Charles D Blanke; Al Benson; Qiqi Deng; Steven R Alberts; Thierry Andre; Norman Wolmark; Axel Grothey; Daniel Sargent Journal: J Clin Oncol Date: 2009-12-14 Impact factor: 44.544
Authors: Georgios Antonios Margonis; Faiz Gani; Stefan Buettner; Neda Amini; Kazunari Sasaki; Nikolaos Andreatos; Cecilia G Ethun; George Poultsides; Thuy Tran; Kamran Idrees; Chelsea A Isom; Ryan C Fields; Bradley Krasnick; Sharon M Weber; Ahmed Salem; Robert C G Martin; Charles Scoggins; Perry Shen; Harveshp D Mogal; Carl Schmidt; Eliza Beal; Ioannis Hatzaras; Rivfka Shenoy; Shishir K Maithel; Timothy M Pawlik Journal: HPB (Oxford) Date: 2016-08-13 Impact factor: 3.647