Japanese Approach to colon cancer and the Outcome Dep. of Surgical Oncology Tokyo Medical and Dental...
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Transcript of Japanese Approach to colon cancer and the Outcome Dep. of Surgical Oncology Tokyo Medical and Dental...
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
Thank you for your attention