Epidemiological, Clinical Characteristics and Therapeutic Results for Stage II Colon Cancer: Experience of the Medical Oncology Department of Fez |Biomedgrid

Adjuvant chemotherapy is the standard of care in patients with stage II colorectal cancer (CRC) with high-risk features. The objective of this study is to report survival benefits associated with adjuvant chemotherapy among patients with stage II colon cancer having one or more high risk features [T4 tumors, less than 12 lymph nodes examined (<12LN), positive margins, high-grade tumor, perineural invasion ,and lymphovascular invasion).This is a retrospective study which included 144 patients with stage II CRC treated at the medical oncology department of Fez over a period from December 2009 to November 2020. The Kaplan Meier method was used to estimate the median survival. 65% of patients (n= 93) received postoperative chemotherapy with a female predominance (44 %males 56%females). Microsatellite instability (MSI) was observed in 25 % of patients versus microsatellite stability (Mss) in 38 % of patients. Among the identified risk factors, occlusion, perforations and T4 tumors were observed in 14.8%, 18% and 22.4% of patients respectively. Median overall survival for MSI patients was higher than MSS patients (36 months versus 29 months). The majority of patients with MSS status and risk factors received chemotherapy with a median overall survival of 29 months. Chemotherapy was well tolerated on the hematological and digestive level. The acute toxicities observed were mostly grade 1 or 2. Our study showed an increased overall survival in patients with MSI. However, the indication for adjuvant chemotherapy must take into account the benefit/risk ratio for each patient.