Age-related differences in adjuvant chemotherapy use and outcomes in stage II colon cancer: a retrospective cohort study.
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BACKGROUND: While the benefit of adjuvant chemotherapy in stage II colon cancer remains uncertain, less is known about how age influences its use and associated outcomes in this population. METHOD: Retrospective cohort study. Patients who underwent radical colon cancer surgery, from 2013 to 2018, divided into age groups; 18–49 (young), 50–64 (middle aged), and 65–75 (older) years. To compare the adjuvant therapy and survival of patients with stage II colon cancer in different age groups. RESULTS: At baseline, the young showed fewer comorbidities (16.1% vs. 37.2% vs. 54.9%, p < 0.001) than the middle-aged and older groups, and the pathological results showed worse differentiation types (25.8% vs. 7.4% vs. 6.1%, p = 0.017), but more microsatellite instability-high status (21.51% vs. 9.10% vs.10.57%, p = 0.005). Among patients with stage II colon cancer, young and middle-aged patients were more likely to receive adjuvant chemotherapy [odds ratio (OR): 4.196 (95% confidence interval (CI), 2.247–7.835); 2.610 (95% CI, 1.743–3.910)]. Among patients receiving adjuvant chemotherapy, young and middle-aged patients were more likely to receive multi-drug chemotherapy than older patients [OR: 3.181 (95% CI, 1.255–8.064); 2.642 (95% CI, 1.386–5.036)]. There was no significant difference in survival among patients with stage II colon cancer who underwent surgery alone or surgery combined with adjuvant chemotherapy among different age groups. CONCLUSION: Among patients with stage II colon cancer, young and middle-aged patients were more likely to receive adjuvant chemotherapy and more aggressive chemotherapy regimens, but this was not associated with survival benefits compared to the older age group.