Background/aims: This study was undertaken to assess the prognostic role of histological grade in colon cancer and the efficacy of either oxaliplatin or irinotecan after incorporation into an infusional regimen of 5-fluorouracil and leucovorin in patients with high-grade metastatic colon cancer.
Methodology: Data from 2409 consecutive and eligible patients with colon cancer from a single institute was used to assess the impact of histological grade on survival and the efficacy of the two doublet regimens on patients with metastatic colon cancer relative to histological grade.
Results: High histological grade has unfavorable outcome for patients with stage III (p=0.021) or stage IV (p=0.003) colon cancer but not for those with stage I (p=0.703) or stage II (p=0.767) colon cancer. Progression free survival and overall survival in patients with high-grade metastatic colon cancer were not improved by the addition of irinotecan or oxaliplatin to the infusional 5-fluorouracil + leucovorin regimen.
Conclusions: Histological grade is a prognostic factor in stage III/IV colon cancer but not in stage I/II. Oxaliplatin and irinotecan may not enhance the efficacy of infusional 5-fluorouracil + leucovorin in the treatment of high-grade metastatic colon cancer.