Abstract
Background
Additive chemotherapeutic treatment of UICC-stage -III / IV colon cancer with fluorouracil,
leucovorin and oxaliplatin is widely accepted as current standard of treatment after
R0-resection. However, as patients´ survival is increasing, long-term side effects
of chemotherapeutic agents such as second cancer development are becoming increasingly
important.
Patients
We therefore investigated a total of 2 856 Patients with UICC-stage III / IV colon
cancer, 223 of whom (7.8%) had developed a subsequent second cancer.
Results
Median follow-up was 73.2 months (range 209.9 months, 95%-CI 69.8-76.9). Most frequent
second cancers were prostate cancer (18.4%), colon cancer (16.1%), breast cancers
(8.1%), lung cancer (8.1%), rectal cancer (4.9%) and uterine cancer (4.9%). However,
in comparison to non-treated patients this did not represent a significantly increased
risk for subsequent second cancer in patients after treatment with additive chemotherapy.
Of interest, our data suggest a significantly decreased second cancer rate in patients
treated with FOLFOX compared to FUFOL for additive treatment.
Conclusions
Second cancer development was not increased after additive chemotherapy for colon
cancer, which is a novel aspect in the ongoing discussions on reduction of adjuvant
treatment to 3 months or treatment of lymph node negative patients.
Novelty and Impact Statement
To our knowledge, this is the first population-based study analyzing second cancer
development after additive chemotherapy in patients with UICC III-IV colon cancer.
The results have an important impact on the surveillance and long-term follow-up of
cancer patients.
Keywords
Abbreviations:
CI (confidence interval), CRC (colorectal cancer), CTx (chemotherapy), FOLFOX (folinic acid, fluorouracil and oxaliplatin), 5-FU (5-fluoruracil), HR (hazard ratio), ICD (International Classification of Diseases), Ox (oxaliplatin), UICC (Union Internationale Contre le Cancer)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: July 15, 2022
Accepted:
July 3,
2022
Received in revised form:
December 18,
2021
Received:
February 7,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
