Effects of adjuvant chemotherapy on recurrence, survival, and quality of life in stage II colon cancer patients: a 24-month follow-up

Abstract

Purpose

The purpose of this cohort study was to investigate the association of adjuvant chemotherapy with quality of life (QoL), survival, and recurrence over the 24 months following diagnosis in stage II colon cancer patients.

Methods

Overall, 453 patients were recruited from North Carolina from 2009 to 2011 and interviewed with a closed-ended survey detailing quality of life, health behaviors, treatment, and cancer recurrence at three times points: diagnosis, 12-, and 24-months post-diagnosis; mortality was obtained via the National Death Index.

Results

In sum, 265 patients received chemotherapy. Receipt of chemotherapy exhibited an inverse association with total Functional Assessment of Cancer Treatment (FACT)-General (P < 0.01), FACT-Colorectal (P < 0.01), physical (P < 0.01), emotional (P = 0.02), and functional (P < 0.01) well-being; the inverse association between receiving chemotherapy and emotional well-being persisted for Caucasians but not African Americans (P interaction = 0.049). Those who received chemotherapy demonstrated significantly higher odds of cancer recurrence (odds ratio (OR) 2.74; 95 % confidence interval (CI) 1.18, 6.35) and all-cause mortality (OR: 1.95; 95 % CI: 1.05, 3.62).

Conclusions

In this study, stage II colon cancer patients who received chemotherapy treatment were more likely to have poor QoL, recurrence, and all-cause mortality after 24 months compared to those who did not receive chemotherapy. Future research focusing on subtypes of chemotherapy treatment, as well as a longer follow-up period, is needed.

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Fig. 1

Abbreviations

QoL:

Quality of life

FACT-C:

Functional assessment of cancer therapy-colorectal

SF-12:

Medical outcomes short form 12

FACT-G:

Functional assessment of cancer therapy-general

P/S/E/FWB:

Physical, social, emotional, and functional well-being

CCS:

Colorectal cancer subscale

TOI-PFC:

Trial outcome index-physical/functional/colorectal

PCS:

Physical component score of SF-12

MCS:

Mental component score of SF-12

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Acknowledgments

This work was supported by a research grant from American Cancer Society (RSGT-08-094-CPPB).

The sponsors were not involved in the design of the study or in the data analyses or manuscript elaboration.

Conflict of interest

The authors declare that they have no competing interests.

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Correspondence to Ka He.

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Lewis, C., Xun, P. & He, K. Effects of adjuvant chemotherapy on recurrence, survival, and quality of life in stage II colon cancer patients: a 24-month follow-up. Support Care Cancer 24, 1463–1471 (2016). https://doi.org/10.1007/s00520-015-2931-2

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Keywords

  • Colon cancer
  • Chemotherapy
  • Quality of life
  • Survival
  • Recurrence