In 2011, about 101,340 Americans have been diagnosed with colon cancer, a leading worldwide cause of both illness and death, with around one third of cancers being diagnosed as stage III, or node-positive disease. A study published in the January issue of The Journal of the National Cancer Institute reveals that patients with Stage III colon cancer have an improved rate of survival if they receive an adjuvant treatment of oxaliplatin added to 5-fluorouracil (5FU).

To improve outcomes in patients with stage III colon cancer, researchers added oxaliplatin to 5FU in randomized clinical trials (RCTs). The effect of this combined therapy is only known in RCTs. Furthermore, less than 2% of colon cancer patients enroll in RCTs, and those who do are generally younger, healthier and less racially diverse, compared with the overall cancer patient population.

Hanna K. Sanoff M.D., and assistant professor of Medicine, Hematology and Oncology at the University of Virginia School of Medicine and her team set out to determine the effects of combined therapy in stage III colon cancer patients in the general population by collecting patient data from the Surveillance, Epidemiology, and End Results registry linked to Medicare claims (SEER-Medicare), as well as from other cancer registries.

Within 120 days of surgery, all stage III colon cancer patients aged 75 years or younger were administered with chemotherapy. The researchers compared overall survival (OS) between patients who received standard chemotherapy treatment with those who received the combination therapy and discovered that the combination therapy with oxaliplatin proved just as effective as in patients from RCTs. They noted that adding oxaliplatin to the standard chemotherapy improved survival across different practice settings, including in older and minority patients and those with greater comorbidity.

The researchers say:

“Physicians and patients should be reassured from our findings that oxaliplatin is associated with marginally but consistently superior survival for patients diagnosed before age 75 years in community settings.”

The researchers feel that because the combined therapy has now proven to be efficient in the general population, it is important to focus on high-risk subgroups, such as patients aged 75 years or older, racially diverse minorities, and those with co morbid conditions.

Written by Petra Rattue