In a new study from Uppsala University, researchers find that many patients with colon cancer do not need any chemotherapy.
In addition, among patients who benefit from chemotherapy, it does not have to be as intense for everyone.
Colon cancer is usually treated with surgery but to reduce the risk for recurrence chemotherapy is also administered in some cases.
Thanks to an improved care in later years the recurrence risk has decreased, which can affect the benefit of chemotherapy that is often accompanied by harmful adverse effects.
In the current study, the researchers analyzed data from all Swedish patients that underwent surgery for colon cancer in the years 2007–2012.
They aimed to determine whether surgery, given today’s treatment and care, is justified to administer chemotherapy to reduce recurrence risk.
They analyzed data from more than 14,000 patients.
The results showed that the recurrence risk after surgery was 5% in the least advanced stage, 12% in more deep tumors, i.e. stage II, and 33% when there were lymph node metastases, that is stage III.
These rates are lower than those seen in historical material.
The team estimated that for many patients in stage II, chemotherapy in combination with surgery would mean that two recurrences could be avoided per one hundred treated patients.
For many stage III patients they found that four to five recurrences per hundred treated patients could be avoided with one chemotherapy agent, and an additional three per hundred treated using two chemotherapy agents.
Their conclusion is that tumor classification and risk factors can help identify large patient groups characterized by such a low recurrence rate.
It is questionable whether chemotherapy in motivated.
The study has been published in the journal Diseases of the Colon and Rectum.
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