This study investigated the effectiveness of chemotherapy after surgery in stage 2 colorectal cancer (CRC). Researchers suggested that this treatment may result in survival improvement but should be individualized.

CRC affects 145,600 adults in the US every year. Treatment for this disease is guided by stage at diagnosis. Surgery is recommended in patients with early CRC. Patients with stage 3 CRC also receive chemotherapy after surgery. Chemotherapy affects specific tumor proteins necessary for tumor growth. It can be used after surgery to kill tumor cells left behind.

Prior studies, comparing stage 2 CRC patients treated with and without chemotherapy showed contradictory results. Some studies suggest a survival improvement while others show no significant effect. It is not clear which patients with stage 2 CRC could benefit from chemotherapy after surgery.

This study reviewed 29 other studies and included information about 183,749 participants. Overall survival, disease-specific survival and disease-free survival (DFS; time from treatment to disease progression) were measured.

Patients who received chemotherapy had a 39% improvement in the odds of better overall survival. They also had a 27% improvement in disease-specific survival and a 41% improvement in the odds of a better DFS.  

In patients with 2 or more risk factors overall survival improved by 41% and DFS by 30% with chemotherapy. This improvement was also seen in patients with colon cancer. 

Chemotherapy improved overall survival (by 42%) and DFS (by 25%) in patients with stage 4 tumors. It also improved overall survival and DFS in patients with positive lymph nodes spread. Patients with tumors with poor differentiation or who received emergency surgery also had better survival with chemotherapy.

This study concluded that chemotherapy after surgery in stage 2 CRC might be a good treatment option for specific patients.

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