Post on 31-Dec-2015
Japanese Approach to colon cancer and the Outcome
Dep. of Surgical OncologyTokyo Medical and Dental University
Kenichi Sugihara
Overall Survival
Colon Ca (n=3061)
P = 0.0033
year
Surv
ival
rate
0 1 2 3 4 5 6 7 8 9 100.0
0.2
0.4
0.6
0.8
1.0
Rectal Ca (n=1393)
84.6%
80.6%
1997 〜 2000 in 18 hospitals
median follow-up time: 71 months
OS; Stage II Colon Cancer
N 5Y-OS
800, 93.5%
914, 88.8%
195, 81.7%
92, 82.1%
128, 91.3%
743, 77.4%
189, 55.5%P<0.0001
Stage I
Stage IIA
Stage IIB
Stage IIC
Stage IIIA
Stage IIIB
Stage IIIC
year
Surv
ival
rate
0 1 2 3 4 5 6 7 8 9 100.0
0.2
0.4
0.6
0.8
1.0TNM 7th ed.
N 5Y-OS
800, 93.5%
914, 88.8%
195, 81.7%
92, 82.1%
128, 91.3%
743, 77.4%
189, 55.5%P<0.0001
Stage I
Stage IIA
Stage IIB
Stage IIC
Stage IIIA
Stage IIIB
Stage IIIC
year
Surv
ival
rate
0 1 2 3 4 5 6 7 8 9 100.0
0.2
0.4
0.6
0.8
1.0
TNM 7th ed.
OS; Stage III Colon Cancer
Randomized Studies of Adjuvant Chemotherapy in Japan
Trials Regimen Duration(months)
Stage No. of Pts
Enrolment
JCOG0205
5FU+l-LV vs. UFT+LV
6 Stage IIIColon cancer
1101 completed in Nov. 2006
JCOG0910
CapecitabineVs. S-1
6 Stage IIIColon cancer
1550 started in March 2010
ACTS-CC UFT+LVVs. S-1
6 Stage IIIColon cancer
1530 completed in June 2009
SACURA UFT vs. surgery alone
12 Stage IIColon cancer
2024 completed in July 2010
ACTS-CC 02
UFT+LVvs. SOX
6 anyTN2Colon cancer
1200 started in April 2010
ACTS-RC UFT vs. S-1 12 Stage II, IIIRectal cancer
961 completed in March 2009
JFMC37 Capecitabine 6 vs 12 Stage IIIColon cancer
1306 completed in Dec. 2009
UFT/LV vs. 5FU/LVJCOG 0205: Phase III non-inferiority study
Stage IIIColon Cancer
(n=1,101)R
UFT/LV (oral) (n=551)
5FU/LV (RPMI) (n=550)
Primary endpoint : DFSSecondary endpoint : OS, Safety
Feb. 2003 - Oct. 2006
3 yrs 4 yrs 5 yrs0.5
0.550.6
0.650.7
0.750.8
0.850.9
0.951
3 yrs 4 yrs 5 yrs0.5
0.6
0.7
0.8
0.9
1
78.3 % 75.0 % 73.8 %
90.3 %94.2%88.2 %
Disease Free Survival Overall Survival
Mortality/Morbidity
Surgery of Colon Cancer
No. Mortality
118,426 0.7%
rt. colectomy/hemicolectomy
No.
39,386
Anastomotic Leakage
1.5%high anterior resection 17,418 2.5%
National Survey of Digestive Surgery by the Japanese Society of Gastroenterological Surgery 1,191,643 surgeries between 2006 and 2008
high/low anterior resection 55,557 0.34%
APR 11908 0.7%
Differences of Colon Cancer Carebetween Japan and Western
Scope of LN dissection
Histopathological examination of resected specimens
Surveillance after surgery
Strategy for liver metastasis
Medical care system/Medical insurance system
JSCCR
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