Outcomes of adjuvant oral versus intravenous fluoropyrimidines for high-risk stage II or stage III colon adenocarcinoma: A propensity score-matched, nationwide, population-based cohort study

Jiaqiang Zhang, Yu Chun Yen, Lei Qin, Chia Lun Chang, Kevin Sheng Po Yuan, Alexander T.H. Wu, Szu Yuan Wu

Research output: Contribution to journalArticle

Abstract

Objective: We conducted this propensity score (PS)-matched, nationwide, population-based cohort study to estimate the effects of adjuvant oral or intravenous (IV) fluoropyrimidine in patients with high-risk stage II or III colon adenocarcinoma. Design: Using PS matching, we minimized the confounding effects on adjuvant oral or IV fluoropyrimidine outcomes in patients with high-risk stage II or III resectable colon adenocarcinoma. Setting: We selected patients from the Taiwan Cancer Registry database receiving adjuvant fluoropyrimidine monotherapy and divided them into those receiving IV fluoropyrimidine (IV group) and those receiving oral fluoropyrimidine (oral group). Results: In both univariate and multivariate Cox regression analyses, the adjusted hazard ratio (aHR) derived for the oral group was 1.34 (95% CI: 1.19-1.51) compared with the IV group. Moreover, in both univariate and multivariate analyses, aHR derived for significant independent prognostic risk factors for poor overall survival were male sex, age ≥ 60 years old, pathologic stage III, right-sided colon cancer, low income, and high Charlson comorbidity index. However, intergroup differences were not significant among female patients or patients < 60 years old on multivariate analysis, including no difference in overall survival. Conclusions: Adjuvant IV fluoropyrimidine is more suitable than adjuvant oral fluoropyrimidine for patients with stage II colon adenocarcinoma who have high-risk pathologic features or stage III colon adenocarcinoma.

Original languageEnglish
Pages (from-to)4157-4165
Number of pages9
JournalJournal of Cancer
Volume11
Issue number14
DOIs
Publication statusPublished - Jan 1 2020

Keywords

  • Colon adenocarcinoma
  • Fluoropyrimidine
  • Intravenous
  • Mortality
  • Oral

ASJC Scopus subject areas

  • Oncology

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