Partnered status and receipt of guideline‐concordant adjuvant chemotherapy among patients with colon cancer

Abstract

Background Partnered status is an independent predictor of clinical outcomes, including overall survival, among patients with cancer. However, the mechanisms by which partnered status impacts survival are not fully understood and to the authors' knowledge the associations between partnered status and the specific attributes of chemotherapy have not been studied to date. Methods The current study was an observational study of patients with resected American Joint Committee on Cancer (AJCC) stage III colon cancer diagnosed from 2008 through 2015 and recruited from an academic cancer center and 2 large community oncology practices. Outcome measures were specific attributes of adjuvant chemotherapy. Partnered status (partnered vs unpartnered) was the primary independent variable. Bivariate comparisons between independent variables and the primary outcomes were performed. Associations between partnered status and the outcomes also were analyzed using multivariable generalized estimating equations using a logit link. Results Data were collected from 436 patients. Of these patients, approximately 65% were from community oncology practices. Approximately 62% were partnered (married or living with a partner), and approximately 86% received adjuvant chemotherapy. Among these individuals, 87% received multiagent chemotherapy and 65% completed 6 months of therapy. Partnered patients were found to have a higher odds of completing chemotherapy (odds ratio, 1.98; 95% CI, 1.04‐3.77). Conclusions In this innovative investigation of the associations between partnered status and specific attributes of curative‐intent chemotherapy, approximately 35% of patients terminated chemotherapy early. Having a partner increased the odds of completing therapy, which may be one mechanism through which having a partner improves disease‐specific outcomes among patients with colon cancer. Identifying those aspects of partner support that can be reproduced with community or clinical personnel may help unpartnered patients to complete the recommended course of curative‐intent chemotherapy.

A population-based study of invitation to and participation in clinical trials among women with early-stage breast cancer

“…[15,17] Married patients are more likely to complete curative-intent chemotherapy and have improved cancer-related and overall survival compared to unmarried patients. [26,27] Spouses/partners may value treatment more than patients themselves do, and may urge patients to consider options beyond standard therapy. [28] It is possible that unmarried patients are less likely to participate in clinical trials in part because they lack the social, emotional, and tangible support provided by a spouse/partner.…”