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Japanese Approach to colon cancer and the Outcome

Japanese Approach to colon cancer and the Outcome. Kenichi Sugihara. Dep. of Surgical Oncology Tokyo Medical and Dental University. Overall Survival. 1997 〜 2000 in 18 hospitals. 1.0. 84.6%. Colon Ca (n=3061). 0.8. P = 0.0033. Survival rate. 80.6%. 0.6. Rectal Ca (n=1393).

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Japanese Approach to colon cancer and the Outcome

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  1. Japanese Approach to colon cancer and the Outcome Kenichi Sugihara Dep. of Surgical Oncology Tokyo Medical and Dental University

  2. Overall Survival 1997 〜 2000 in 18 hospitals 1.0 84.6% Colon Ca(n=3061) 0.8 P = 0.0033 Survival rate 80.6% 0.6 Rectal Ca(n=1393) 0.4 0.2 median follow-up time: 71 months 0.0 0 1 2 3 4 5 6 7 8 9 10 year

  3. OS; Stage II Colon Cancer TNM 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% 1.0 Stage I 0.8 Stage IIA Survival rate Stage IIB 0.6 Stage IIC 0.4 Stage IIIA 0.2 Stage IIIB P<0.0001 Stage IIIC 0.0 0 1 2 3 4 5 6 7 8 9 10 year

  4. OS; Stage III Colon Cancer TNM 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% 1.0 Stage I 0.8 Stage IIA Survival rate Stage IIB 0.6 Stage IIC 0.4 Stage IIIA 0.2 Stage IIIB P<0.0001 Stage IIIC 0.0 0 1 2 3 4 5 6 7 8 9 10 year

  5. Randomized Studies of Adjuvant Chemotherapy in Japan

  6. UFT/LV vs. 5FU/LVJCOG 0205: Phase III non-inferiority study StageIII Colon Cancer (n=1,101) R UFT/LV(oral) (n=551) 5FU/LV(RPMI) (n=550) Feb. 2003 - Oct. 2006 Primary endpoint：DFS Secondary endpoint：OS, Safety Disease Free Survival Overall Survival 94.2% 90.3 % 88.2 % 78.3 % 75.0 % 73.8 %

  7. Mortality/Morbidity National Survey of Digestive Surgery by the Japanese Society of Gastroenterological Surgery 1,191,643surgeries between 2006 and 2008 No. Mortality 118,426 Surgery of Colon Cancer 0.7% high/low anterior resection 55,557 0.34% APR 11908 0.7% Anastomotic Leakage No. 39,386 rt. colectomy/hemicolectomy 1.5% high anterior resection 17,418 2.5%

  8. Differences of Colon Cancer Carebetween Japan and Western • Scope of LN dissection • Histopathologicalexamination • of resected specimens • Surveillance after surgery • Strategy for liver metastasis • Medical care system/Medical insurance system JSCCR

  9. Thank you for your attention

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