While the major Western guidelines recommend adjuvant chemotherapy for patients having Stage II colorectal cancer (CRC) with 'high-risk' features, e.g., pT4 and lymphovascular involvement, the survival benefit has not been… Click to show full abstract
While the major Western guidelines recommend adjuvant chemotherapy for patients having Stage II colorectal cancer (CRC) with 'high-risk' features, e.g., pT4 and lymphovascular involvement, the survival benefit has not been confirmed. To understand the actual clinical practice for this patient subgroup in Japan, we performed a questionnaire survey of specialist institutions regarding two topics: institutional policy of adjuvant chemotherapy, and the percentage of patients receiving adjuvant chemotherapy among 'high-risk' Stage II CRC patients. Among the 55 responders out of 60 institutions (response rate, 91.7%), 80.0% did not routinely administer adjuvant chemotherapy for 'high-risk' Stage II patients. The median percentage of 'high-risk' Stage II patients receiving adjuvant chemotherapy was 25%, with ≤30% in 35 institutions, and >60% in 12. In summary, performance of adjuvant chemotherapy for patients with 'high-risk' Stage II CRC varied substantially, even among these specialist institutions, and a majority of patients received no adjuvant chemotherapy.
               
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