Adjuvant treatment of early colon cancer with micrometastases: results of a national survey

J Surg Oncol. 2012 Aug 1;106(2):119-22. doi: 10.1002/jso.23057. Epub 2012 Feb 3.

Abstract

Background and objectives: Optimal adjuvant treatment for patients with Stage I/II colon cancer with micrometastases (MM) is unknown. Because there is no known adjuvant treatment-related benefit, we evaluated whether MM influenced treatment decisions.

Method: Review of a national survey from members of the SSO and ASCO.

Results: Of 602 survey responses, 305 (51%) stated that MM had significant prognostic value, 250 (42%) were unsure, and 47 (7%) did not believe that MM held prognostic value. Three hundred seventy-four (63%) would offer adjuvant therapy in the setting of MM, while 222 (37%) would not. Only 15% routinely performed IHC on lymph nodes. Medical oncologists were more likely to recommend adjuvant therapy compared to surgical oncologists (68% vs. 51%, P = 0.001).

Conclusions: MM in colon cancer apparently influenced adjuvant treatment decisions absent known prognostic benefit. Prospective trials are needed to improve the selection of patients for systemic chemotherapy in early, node-negative colon cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chemotherapy, Adjuvant
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / pathology*
  • Colonic Neoplasms / surgery
  • Female
  • Health Care Surveys
  • Humans
  • Immunohistochemistry
  • Lymphatic Metastasis
  • Male
  • Medical Oncology / statistics & numerical data
  • Middle Aged
  • Neoplasm Micrometastasis
  • Neoplasm Staging
  • Polymerase Chain Reaction
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Predictive Value of Tests
  • Prognosis
  • Societies, Medical
  • Surveys and Questionnaires
  • United States