The addition of chemotherapy after surgery did not provide a survival benefit among patients with young-onset colon cancer, according to a study published in JAMA Surgery.1

A large number of patients with early-stage colon cancer receive adjuvant chemotherapy despite a paucity of data showing a survival benefit. Younger patients often receive more aggressive therapy, but multiagent chemotherapy has not been demonstrated to improve survival in this population.

In this cohort study, overall survival was evaluated among patients with colon cancer who were treated with surgery or surgery plus adjuvant chemotherapy. The data were stratified by age group and tumor stage.

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The data were from 3143 patients aged 18 to 75 from the U.S. Department of Defense’s Central Cancer Registry and Military Health System medical claims database. Patients were diagnosed between 1998 and 2007, and the study was conducted between 2015 and 2016.

Patients age 18 to 49 (odds ratio, 2.48; 95% CI, 1.42-4.32) and 50 to 64 (odds ratio, 2.66; 95% CI, 1.70-4.18) were more likely to receive adjuvant multiagent chemotherapy compared with elderly patients.

There was no significant difference in overall survival between the age groups among patients who received adjuvant chemotherapy. Younger and middle-age patients who underwent surgery had better survival compared with elderly patients only.

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The authors concluded that these findings suggest that chemotherapy may be overused in younger and middle-aged patients with colon cancer.


  1. Manjelievskaia J, Brown D, McGlynn KA, Anderson W, Shriver CD, Zhu K. Chemotherapy use and survival among young and middle-aged patients with colon cancer. JAMA Surg. 2017 Jan 25. doi: 10.1001/jamasurg.2016.5050 [Epub ahead of print]