Prognosis of Stage IIIA Colorectal Cancer Patients with or without Postoperative Adjuvant Chemotherapy

Introduction. The new definition of stage IIIA colorectal cancer (CRC) was introduced in the Seventh Edition of the American Joint Committee on Cancer (AJCC 7th). Because the outcomes of patients with stage IIIA CRC are not worse than those of patients with stage II disease, we evaluated whether chemotherapy would also benefit this group of patients.Patients and Methods. Patients who received curative surgery and were diagnosed with stage IIIACRC between 1995 and 2006 were enrolled and analyzed.Results. Total 149 patients diagnosed stage IIIA colorectal cancer were enrolled. In these patients, 31 were T1 stage with only one found recurrence. Whether adjuvant therapy performed or not, there was no significant meaning for their prognosis. For T2 patients, higher recurrence rate was noted with N1b patients. Though no statistical meaning achieved, for those without chemotherapy, mucinous type, insufficient lymph node exam, higher recurrent rate were noted. The new AJCC 7th made difference in T1N2a group. Though only 5 patients collected in this study, none was found tumor recurrence, and the result was compatible with the new staging system.Conclusion. Adjuvant therapy is recommended for stage IIIA CRC patients with T2 disease. However, adjuvant chemotherapy may not be beneficial for stage IIIA CRC patients with T1 disease.