Real World Evidence: Treatment of Patients with NonMetastatic Colon Cancer in a Community Hospital in Argentina: A Retrospective Cohort Study

Background: The addition of adjuvant chemotherapy (ACT) to the surgical treatment of locally advanced colon cancer (CC) was shown to reduce relapses in stage III disease, although it remains controversial in stage II. However, an underutilization of ACT in stage III patients was reported. Data on use of ACT in stage II and in older patients in the “real world” in developing countries are limited. We aimed to describe management and outcome of non-metastatic colon cancer patients in a community hospital in Argentina. Methods: We retrospectively reviewed clinical charts of 99 patients with non-metastatic CC admitted in our Department between 2007 and 2016 extracting data on surgical treatment and chemotherapy use. Results: Emergency surgery was performed in 36.2% of cases. Near 72% of patients had 12 or more lymph nodes examined. Adjuvant chemotherapy was delivered to 93.1% of patients with stage III, to 38.1% of patients with stage II disease, and to 94.1% of stage III patients older than 70 years. Ninety six percent of patients with stage III disease received oxaliplatin-based chemotherapy. Similar proportions (near 50%) of patients <70 and > 70 years completed chemotherapy. After the median follow up of 2.1 years, (Interquartile range, 1.4 to 4.4 years), 16.2% of patients had a relapse. Conclusion: A guideline-compliant lymphadenectomy and ACT were performed in the majority of patients with CC in the routine practice in a developing country. The proportion of emergency surgical interventions is high. High proportion of older patients received ACT, and its completion rate in this subgroup is similar to younger patients.