title: Evaluation of relapse-free survival in T3N0 colon cancer: the role of chemotherapy, a multicentric retrospective analysis.
abstract: BACKGROUND
  Adjuvant chemotherapy (AC) in Stage II Colon Cancer (CC) is still under debate. Choice should be based on patients and disease characteristics. According to guidelines AC should be considered in high-risk T3N0 patients. No data are available for better option in low-risk patients. The aim of the study is to retrospectively evaluate relapse-free survival (RFS) and disease-free survival (DFS) according to treatment received in T3N0 CC.
  
  
  METHODS
  RFS and DFS are evaluated with Kaplan-Meier method. Multivariate Cox proportional hazard model was developed using stepwise regression, enter limit and remove limit were p = 0.10 and p = 0.15, respectively.
  
  
  RESULTS
  834 patients with T3N0 CC were recruited. Median age was 69 (29-93), M/F 463/371, 335 low-risk patients (40.2%), 387 high-risk (46.4%), 112 unknown (13.4%); 127 (15.2%) patients showed symptoms at diagnosis. Median sampled lymph nodes were 15 (1-76); 353 (42.3%) patients were treated with AC. Median follow up was 5 years (range 3-24). The 5-years RFS was 78.4% and the 5-years DFS was 76.7%. At multivariate analysis symptoms, lymph nodes, and adjuvant chemotherapy were prognostic factors for RFS. AC is prognostic factor for all endpoints. In low-risk group 5-years RFS was 87.3% in treated patients and 74.7% in non-treated patients (p 0.03); in high-risk group was respectively 82.7% and 71.4% (p 0.005).
  
  
  CONCLUSIONS
  Data confirmed the role of known prognostic factors and suggest the relevance of adjuvant chemotherapy also in low-risk stage II T3N0 CC patients. However, the highest risk in low-risk subgroup should be identified to be submitted to AC.
authors: Medical Oncology Unit-ASL Frosinone, Italy.
authors: Roberta
authors: R
authors: Grande
authors: Domenico
authors: D
authors: Corsi
authors: Raffaello
authors: R
authors: Mancini
authors: Donatello
authors: D
authors: Gemma
authors: Fabrizio
authors: F
authors: Ciancola
authors: Isabella
authors: I
authors: Sperduti
authors: Lorena
authors: L
authors: Rossi
authors: Agnese
authors: A
authors: Fabbri
authors: Maria G
authors: MG
authors: Diodoro
authors: Enzo
authors: E
authors: Ruggeri
authors: Germano
authors: G
authors: Zampa
authors: Sara
authors: S
authors: Bianchetti
authors: Teresa
authors: T
authors: Gamucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012008:Recurrence; D012189:Retrospective Studies