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


METHODS
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.
Cedars Sinai Medical Center, Los Angeles, California, USA.
Scott S
SS
Short
Alexander
A
Stojadinovic
Aviram
A
Nissan
Zev
Z
Wainberg
Deepti
D
Dhall
Kathy
K
Yao
Anton
A
Bilchik
D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data; D008875:Middle Aged; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging; D016133:Polymerase Chain Reaction; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011379:Prognosis; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States