Background The aim of the present EURECCA international comparison is to compare adjuvant chemotherapy and relative survival of patients with stage II colon cancer between European countries. Methods Population-based national cohort data (2004-2009) from the Netherlands (NL), Denmark (DK), Sweden (SE), England (ENG), Ireland (IE), and Belgium (BE) were obtained, as well as single-centre data from Lithuania. All surgically treated patients with stage II colon cancer were included. The proportion of patients receiving adjuvant chemotherapy was calculated and compared between countries. Besides, relative survival was calculated and compared between countries. Results Overall, 59,154 patients were included. The proportion of patients receiving adjuvant chemotherapy ranged from 7.1% to 29.0% (p < 0.001). Compared with NL, a better adjusted relative survival was observed in SE (stage II: relative excess risks (RER) 0.53, 95% confidence interval (CI) 0.44-0.64; p < 0.001), and BE (stage II: RER 0.84, 95% CI 0.76-0.92; p < 0.001), and in IE for patients with stage IIA disease (RER 0.80, 95% CI 0.65-0.98; p = 0.03). Conclusion The proportion of patients with stage II colon cancer receiving adjuvant chemotherapy varied largely between seven European countries. No clear linear pattern between adjuvant chemotherapy and adjusted relative survival was observed. Compared with NL, SE and BE showed an improved adjusted relative survival for stage II disease, and IE for patients with stage IIA disease only. Further research into selection criteria for adjuvant chemotherapy could eventually lead to individually tailored, optimal treatment of patients with stage II colon cancer.
Bibliographical noteFunding Information:
National datasets from the Netherlands Cancer Registry (NL), the Danish Colorectal Cancer Group database (DK), the Swedish Colorectal Cancer Registry (SE), the English National Cancer Registration Service database Cancer Analysis System (ENG), the National Cancer Registry Ireland (IE), and the Belgian Cancer Registry (BE) were included. Moreover, we obtained single-centre data from the Hospital of Lithuanian University of Health Sciences Kaunas Clinics (LT).
EURECCA was funded by the European Society of Surgical Oncology (ESSO) . The funding source had no role in the study design, data collection, analysis, interpretation of the data, writing of the manuscript, or the decision to publish.
© 2016 Elsevier Ltd. All rights reserved.
- Adjuvant chemotherapy
- Colon cancer
- International comparison
- Stage II