Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer

Background: It was a difficult question to identify candidates who would benefit most from adjuvant chemotherapy in stage II colon cancer because of the paucity of relevant conclusive clinical trial results. We aimed to assess if mucinous adenocarcinoma (MUA) could be an indicator for the efficacy o...

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Main Authors: Yong Huang, Kuanxue Ge, Guangshun Fu, Junfeng Chu, Wei Wei
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-06-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fmed.2020.00205/full
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author Yong Huang
Kuanxue Ge
Guangshun Fu
Junfeng Chu
Wei Wei
author_facet Yong Huang
Kuanxue Ge
Guangshun Fu
Junfeng Chu
Wei Wei
author_sort Yong Huang
collection DOAJ
description Background: It was a difficult question to identify candidates who would benefit most from adjuvant chemotherapy in stage II colon cancer because of the paucity of relevant conclusive clinical trial results. We aimed to assess if mucinous adenocarcinoma (MUA) could be an indicator for the efficacy of adjuvant chemotherapy in stage II colon cancer.Methods:Using SEER*Stat software V.8.3.5, eligible patients were then recruited from the SEER database. A χ2 test was applied to compare the distribution of different categorical variables between nonmucinous adenocarcinoma (NMUA) and MUA groups. We then used the Kaplan–Meier method to analyze overall survival (OS) of different histological types in stage II colon cancer, and the log-rank test was then used to assess the OS differences. The Cox proportional regression risk models were also built in our analyses to eliminate potential crossed bias from other prognostic factors.Results:A total of 50,065 patients diagnosed with stage II colon cancer were recruited from the SEER database from 2004 to 2011; all the patients were divided into two groups, including NMUA (n = 44,785) and MUA (n = 5,280). The Cox analysis of the histological type indicated that the survival difference between MUA and NMUA failed to reach statistical significance in stage II colon cancer (P = 0.360). In NMUA, patients treated with adjuvant chemotherapy were independently associated with 37.2% decreased risk of overall mortality compared with those not [hazard ratio (HR) = 0.628, 95% confidence interval (CI) = 0.601-1.656, P < 0.001]; in MUA, the number increased to 41.5% (HR = 0.585, 95% CI = 0.515-0.665, P < 0.001).Conclusions:Our study showed that the survival difference between MUA and NMUA failed to reach statistical significance in stage II colon cancer. More importantly, our study had provided the first evidence that chemotherapy would offer higher survival improvement in MUA compared with NMUA in stage II colon cancer; mucinous histology might be an indicator for enhanced survival benefit of chemotherapy in stage II colon cancer.
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spelling doaj.art-addbb9f9bc4a4cd6931e8d0881cb5aa92022-12-21T22:41:06ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-06-01710.3389/fmed.2020.00205538180Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon CancerYong Huang0Kuanxue Ge1Guangshun Fu2Junfeng Chu3Wei Wei4Department of General Surgery, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, ChinaDepartment of Gastroenterology, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, ChinaDepartment of General Surgery, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, ChinaDepartment of Radiotherapy, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, ChinaDepartment of General Surgery, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, ChinaBackground: It was a difficult question to identify candidates who would benefit most from adjuvant chemotherapy in stage II colon cancer because of the paucity of relevant conclusive clinical trial results. We aimed to assess if mucinous adenocarcinoma (MUA) could be an indicator for the efficacy of adjuvant chemotherapy in stage II colon cancer.Methods:Using SEER*Stat software V.8.3.5, eligible patients were then recruited from the SEER database. A χ2 test was applied to compare the distribution of different categorical variables between nonmucinous adenocarcinoma (NMUA) and MUA groups. We then used the Kaplan–Meier method to analyze overall survival (OS) of different histological types in stage II colon cancer, and the log-rank test was then used to assess the OS differences. The Cox proportional regression risk models were also built in our analyses to eliminate potential crossed bias from other prognostic factors.Results:A total of 50,065 patients diagnosed with stage II colon cancer were recruited from the SEER database from 2004 to 2011; all the patients were divided into two groups, including NMUA (n = 44,785) and MUA (n = 5,280). The Cox analysis of the histological type indicated that the survival difference between MUA and NMUA failed to reach statistical significance in stage II colon cancer (P = 0.360). In NMUA, patients treated with adjuvant chemotherapy were independently associated with 37.2% decreased risk of overall mortality compared with those not [hazard ratio (HR) = 0.628, 95% confidence interval (CI) = 0.601-1.656, P < 0.001]; in MUA, the number increased to 41.5% (HR = 0.585, 95% CI = 0.515-0.665, P < 0.001).Conclusions:Our study showed that the survival difference between MUA and NMUA failed to reach statistical significance in stage II colon cancer. More importantly, our study had provided the first evidence that chemotherapy would offer higher survival improvement in MUA compared with NMUA in stage II colon cancer; mucinous histology might be an indicator for enhanced survival benefit of chemotherapy in stage II colon cancer.https://www.frontiersin.org/article/10.3389/fmed.2020.00205/fullmucinous histologysurvival benefitchemotherapystage IIcolon cancer
spellingShingle Yong Huang
Kuanxue Ge
Guangshun Fu
Junfeng Chu
Wei Wei
Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer
Frontiers in Medicine
mucinous histology
survival benefit
chemotherapy
stage II
colon cancer
title Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer
title_full Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer
title_fullStr Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer
title_full_unstemmed Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer
title_short Mucinous Histology Might Be an Indicator for Enhanced Survival Benefit of Chemotherapy in Stage II Colon Cancer
title_sort mucinous histology might be an indicator for enhanced survival benefit of chemotherapy in stage ii colon cancer
topic mucinous histology
survival benefit
chemotherapy
stage II
colon cancer
url https://www.frontiersin.org/article/10.3389/fmed.2020.00205/full
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AT guangshunfu mucinoushistologymightbeanindicatorforenhancedsurvivalbenefitofchemotherapyinstageiicoloncancer
AT junfengchu mucinoushistologymightbeanindicatorforenhancedsurvivalbenefitofchemotherapyinstageiicoloncancer
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