Reports

Review of Colon Cancer Cases in 2012 and Recommendations for Patient Care

A report for DRMC Cancer Committee

8/26/2014

Author: Dr. Bill Gai

We have reviewed colon cancers diagnosed in Danville Regional Medical Center in 2012. Overall, for patients treated locally in Danville Hematology and Oncology, for stage III/IV diseases, 80% or more received treatment as recommended.  For stage II disease, the majority of patients were not recommended for chemotherapy based on available data and guidelines. For diseases not staged, 2 cases were seen locally. One case received treatment; the other case did not receive treatment due to patient’s refusal.

In summary, over the year of 2012, it is felt that based on the data analysis, colon cancers were managed accordingly based on evidence-based-medicine per NCCN guidelines. However, due to limited numbers of patients, no statistically significant conclusions can be drawn.

Recommendations:

In stage II colon cancers, we have data available now to suggest that for patients with microsatellite instabilities (MSI), 5-FU based chemotherapy offers no benefits to patients’ survival; on the contrary, it may even be detrimental to patients; therefore, from now on, all patients with stage II colon cancer will be stratified based on MSI status.  For those with stable MSI, 5-FU based chemotherapy offer small survival, but statically significant, benefits in fit patients.