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Research Article
Weiwei Chen
Guizhou Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8275-9162
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Only 50-70% elderly colon cancer patients could complete a six-month postoperative chemotherapy. It is unknown whether a shorter duration of postoperative capecitabine-alone chemotherapy would not compromise the survival. We thus conducted this study to analyze the association between postoperative chemotherapy duration of capecitabine-alone regimen and cancer specific survival (CSS) in the surgery treated elderly colon cancer patients.
Methods: We performed a retrospective cohort study in surgery treated stage III and high-risk stage II colon cancer patients aged >= 70 from two medical centers. Cox proportional hazard regression models were utilized to calculate crude and adjusted hazard ratios (HRs). The non-linear relationship between postoperative chemotherapy duration and CSS was analyzed through the restricted cubic spline regression analysis, and the threshold effect was calculated by the two-piece-wise Cox proportional hazard model.
Results: A total of 1,217 surgery treated colon cancer patients between August 1, 2013 and September 1, 2019 were reviewed and 257 stage III and high-risk stage II patients aged >= 70 were finally enrolled. Postoperative chemotherapy with capecitabine was delivered in 114 patients and 143 cases only received surgery. The capecitabine duration was generally associated with a 11% risk decrease in death (HR=0.89, 95% confidence interval (CI) 0.82 - 0.96). Non-linearity exploration suggested a threshold effect of capecitabine duration on CSS in stage III disease. The HR for death was 0.79 (95% CI: 0.68 - 0.92) with duration <= 16 (week) while 1.34 (95% CI: 0.91 – 1.97) with duration > 16 (week).
Conclusions: The postoperative capecitabine duration was significantly associated with CSS in elderly colon cancer. However, a threshold effect of capecitabine duration on survival may suggest a short-term chemotherapy could be an alternative for the conventional six-month regimen in the elderly stage III colon cancer.
Keywords
Postoperative chemotherapy, Capecitabine, Colon cancer, Elderly, Survival
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CURRENT STATUS: Published
View the published article at World Journal of Surgical Oncology.
Version 1
Posted 13 Apr, 2021
No community comments so far
Editorial decision: Major Revision
On 08 May, 2021
Review #5 received
Received 30 Apr, 2021
Review #4 received
Received 25 Apr, 2021
Review #3 received
Received 21 Apr, 2021
Review #2 received
Received 20 Apr, 2021
Reviewer #7 agreed
On 13 Apr, 2021
Reviewer #6 agreed
On 12 Apr, 2021
Reviewer #5 agreed
On 11 Apr, 2021
Reviewer #4 agreed
On 10 Apr, 2021
Reviewer #3 agreed
On 10 Apr, 2021
Review #1 received
Received 10 Apr, 2021
Reviewer #2 agreed
On 09 Apr, 2021
Reviews received
Received 08 Apr, 2021
Reviewers invited
Invitations sent on 08 Apr, 2021
Reviewer #1 agreed
On 08 Apr, 2021
Editor assigned
On 07 Apr, 2021
Submission checks complete
On 07 Apr, 2021
Editor invited
On 07 Apr, 2021
First submitted
On 07 Apr, 2021
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A new preprint design is coming!
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See the published version of this preprint at World Journal of Surgical Oncology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Weiwei Chen
Guizhou Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8275-9162
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at World Journal of Surgical Oncology.
Version 1
Posted 13 Apr, 2021
No community comments so far
Editorial decision: Major Revision
On 08 May, 2021
Review #5 received
Received 30 Apr, 2021
Review #4 received
Received 25 Apr, 2021
Review #3 received
Received 21 Apr, 2021
Review #2 received
Received 20 Apr, 2021
Reviewer #7 agreed
On 13 Apr, 2021
Reviewer #6 agreed
On 12 Apr, 2021
Reviewer #5 agreed
On 11 Apr, 2021
Reviewer #4 agreed
On 10 Apr, 2021
Reviewer #3 agreed
On 10 Apr, 2021
Review #1 received
Received 10 Apr, 2021
Reviewer #2 agreed
On 09 Apr, 2021
Reviews received
Received 08 Apr, 2021
Reviewers invited
Invitations sent on 08 Apr, 2021
Reviewer #1 agreed
On 08 Apr, 2021
Editor assigned
On 07 Apr, 2021
Submission checks complete
On 07 Apr, 2021
Editor invited
On 07 Apr, 2021
First submitted
On 07 Apr, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at World Journal of Surgical Oncology.
Background: Only 50-70% elderly colon cancer patients could complete a six-month postoperative chemotherapy. It is unknown whether a shorter duration of postoperative capecitabine-alone chemotherapy would not compromise the survival. We thus conducted this study to analyze the association between postoperative chemotherapy duration of capecitabine-alone regimen and cancer specific survival (CSS) in the surgery treated elderly colon cancer patients.
Methods: We performed a retrospective cohort study in surgery treated stage III and high-risk stage II colon cancer patients aged >= 70 from two medical centers. Cox proportional hazard regression models were utilized to calculate crude and adjusted hazard ratios (HRs). The non-linear relationship between postoperative chemotherapy duration and CSS was analyzed through the restricted cubic spline regression analysis, and the threshold effect was calculated by the two-piece-wise Cox proportional hazard model.
Results: A total of 1,217 surgery treated colon cancer patients between August 1, 2013 and September 1, 2019 were reviewed and 257 stage III and high-risk stage II patients aged >= 70 were finally enrolled. Postoperative chemotherapy with capecitabine was delivered in 114 patients and 143 cases only received surgery. The capecitabine duration was generally associated with a 11% risk decrease in death (HR=0.89, 95% confidence interval (CI) 0.82 - 0.96). Non-linearity exploration suggested a threshold effect of capecitabine duration on CSS in stage III disease. The HR for death was 0.79 (95% CI: 0.68 - 0.92) with duration <= 16 (week) while 1.34 (95% CI: 0.91 – 1.97) with duration > 16 (week).
Conclusions: The postoperative capecitabine duration was significantly associated with CSS in elderly colon cancer. However, a threshold effect of capecitabine duration on survival may suggest a short-term chemotherapy could be an alternative for the conventional six-month regimen in the elderly stage III colon cancer.
Figure 1
Figure 2
Figure 3
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