Prevalence and survival benefit of adjuvant chemotherapy in stage III colon cancer patients: Comparison of overall and age-stratified results by multivariable modeling and propensity score methodology in a population-based cohort

Hines, Rebecca; Bimali, Milan; Johnson, Asal M.; Bayakly, A. Rana; Collins, Tracie C.

doi:10.1016/j.canep.2016.08.004

Cited by 14 publications

(18 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with previous studies [ 2 – 4 , 10 , 16 , 28 – 30 ], our data showed that patients with stage III colon cancer receiving ACT had a statistically significant reduction in mortality compared with those no receiving ACT. Our data also showed that patients aged ≥70 years, Medicaid enrollees, unmarried patients, and patients who resided in the northeast region of the Island at the time of diagnosis were less likely to receive ACT.…”

Section: Discussionsupporting

confidence: 92%

“…Overall, 75% of the study population received ACT. Although comparable with previous population based studies, the percentage patients receiving ACT was higher than the reported in recent studies [ 2 , 4 , 10 , 15 , 19 , 20 ]. This difference might be attributable to the high health insurance coverage in Puerto Rico (96.3%) [ 26 ] and the adherence of health professionals in Puerto Rico to evidence-based treatment guidelines recommended.…”

Section: Discussionsupporting

confidence: 89%

“…Our data also showed that patients aged ≥70 years, Medicaid enrollees, unmarried patients, and patients who resided in the northeast region of the Island at the time of diagnosis were less likely to receive ACT. Patients’ age has been previously reported to be a strong predictor for no receiving ACT [ 10 , 15 , 16 , 19 – 21 , 31 ], despite the fact that several studies, including the present study, have shown a benefit of ACT in older patients [ 2 – 4 , 16 , 32 , 33 ]. Patients aged ≥70 years who received ACT had better survival and lower risk of death compared to those no receiving ACT.…”

Section: Discussioncontrasting

confidence: 52%

See 2 more Smart Citations

Use of adjuvant chemotherapy in patients with stage III colon cancer in Puerto Rico: A population-based study

et al. 2018

View full text Add to dashboard Cite

ObjectiveThis study aims to examine factors associated with the use of adjuvant chemotherapy and the use of oxaliplatin after curative resection in stage III colon cancer patients and assesses the effect of their use in three-year survival.MethodsThis retrospective cohort study was conducted using Puerto Rico Central Cancer Registry-Health Insurance Linkage Database. The study cohort consisted of stage III colon cancer patients with a curative surgery in the period 2008–2012. Multivariate logistic regression was used to estimate adjusted odds ratios. Kaplan-Meier methods and Cox proportional hazards models were used to assess the association between adjuvant chemotherapy and oxaliplatin use and overall survival and risk of death, respectively.ResultsOverall, 75% of the study population received adjuvant chemotherapy during the study period. Factors statistically associated with receiving adjuvant chemotherapy within four months after resection included being married (adjusted odds ratio [AOR] 1.64; 95% CI 1.18–2.28; p = 0.003), and being enrolled in Medicare (AOR 1.68; 95% CI: 1.03–2.75; p = 0.039) or Medicaid and Medicare dual eligible (AOR 1.66; 95% CI: 1.06–2.60; p = 0.028). However, patients aged ≥70 years were less likely to receive adjuvant chemotherapy (AOR 0.22; 95%CI 0.14–0.36; p<0.001).DiscussionWe observed a significant reduction in mortality in adjuvant chemotherapy treated patients. Similarly, patients <70 years treated with oxaliplatin had significantly lower risk of death than those who did not, although for patients ≥70 years no statistical significance was achieved. Future studies should assess effective interventions to reduce barriers to access guideline-based recommended colon cancer treatment.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 52%

See 1 more Smart Citation

Use of adjuvant chemotherapy in patients with stage III colon cancer in Puerto Rico: A population-based study

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Of seventeen studies examining colon cancer, five studies aimed at investigating age disparities in colon cancer survival (Table 2) 16,17,31,32,34 . Six studies used data from The Netherlands 16,17,21,27,30,32 , and five presented data from the U.S.A. 26,31,33,34–54 . The remaining studies used data from Finland 53 , Norway 28 , Germany 29 , Korea 35,36 , and Australia 20 .…”

Section: Resultsmentioning

confidence: 99%

Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review

Pilleron

Gower

Janssen‐Heijnen

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective: To identify patterns of age disparities in cancer survival, using colon and lung cancer as exemplars. Methods: We conducted a systematic review of literature published in EMBASE, MEDLINE, Scopus, and Web of Science according to PRISMA guidelines. We included population-based studies in patients with colon or lung cancer. We assessed the quality of included studies against selected evaluation domains from the QUIPS Tool, and items concerning statistical reporting. We evaluated age disparities using the absolute difference in survival or mortality rates between middle-aged group and the oldest age group, or by describing survival curves. Results: Out of 2,162 references reviewed, we retained 35 studies (15 for colon, 18 for lung, 2 for both sites). Regardless of the cancer site, included studies were highly heterogeneous and often of poor quality. The magnitude of age disparities in survival varied greatly by sex, ethnicity, socio-economic status, stage at diagnosis, cancer site and morphology, the number of nodes examined, and by treatment strategy. Although results were inconsistent for most characteristics, we consistently observed greater age disparities for females with lung cancer compared to males. Also, age disparities increased with more advanced stages for colon cancer and decreased with more advanced stages for lung cancer. Conclusions: Although age is one of the most important prognostic factors in cancer survival, age disparities in colon and lung cancer survival have so far been understudied in population-based research. Further studies are needed to better understand age disparities in colon and lung cancer survival. (PROSPERO registration number: CRD42020151402).

show abstract

“…Because of possible adverse effects on survival due to the side effects of chemotherapeutic agents, chemotherapy is not recommended for elderly patients. However, the use of AC for older patients in stage III colon cancer has been shown to increase survival [ 14 - 16 ]. Although Hernosillo-Rodriguez et al [ 17 ] showed the effect of AC in elderly patients in their study of high risk stage II and stage III colon cancer patients, this study is the first to analyze the effectiveness of AC in elderly stage II colon cancer patients to the author’s knowledge.…”

Section: Discussionmentioning

confidence: 99%

Effect of Adjuvant Chemotherapy on Stage II Colon Cancer: Analysis of Korean National Data

Kim¹,

Won²,

Park³

et al. 2018

Cancer Res Treat

View full text Add to dashboard Cite

PurposeDebates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data.Materials and MethodsA total of 7,880 patientswho underwent curative resection for stage II colon adenocarcinoma between January 2011 andDecember 2014 in Koreawere selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage.ResultsThe median follow-up period was 38 months (range, 1 to 63 months). Chemotherapy was a favorable prognostic factor for either the high- (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.38 to 0.59; p < 0.001) or low-risk group (HR, 0.74; 95% CI, 0.61 to 0.89; p=0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn’t receive chemotherapy. Adding oxaliplatin showed no difference in survival (HR, 1.36; 95% CI, 0.91 to 2.03; p=0.132).ConclusionAdjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.

show abstract

Prevalence and survival benefit of adjuvant chemotherapy in stage III colon cancer patients: Comparison of overall and age-stratified results by multivariable modeling and propensity score methodology in a population-based cohort

Cited by 14 publications

References 41 publications

Use of adjuvant chemotherapy in patients with stage III colon cancer in Puerto Rico: A population-based study

Use of adjuvant chemotherapy in patients with stage III colon cancer in Puerto Rico: A population-based study

Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review

Effect of Adjuvant Chemotherapy on Stage II Colon Cancer: Analysis of Korean National Data

Contact Info

Product

Resources

About