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Age and adjuvant chemotherapy use after surgery for stage III colon cancer.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Schrag, Deborah Cramer, Laura D. Bach, Peter B. Begg, Colin B. |
| Copyright Year | 2001 |
| Abstract | BACKGROUND Randomized trials have established that 5-fluorouracil-based adjuvant chemotherapy following resection of stage III colon cancer reduces subsequent mortality by as much as 30%. However, the extent to which adjuvant therapy is used outside the clinical trial setting, particularly among the elderly, is unknown. METHODS A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results/Medicare-linked database identified 6262 patients aged 65 years and older with resected stage III colon cancer. The primary outcome was chemotherapy use within 3 months of surgery, as ascertained from Medicare claims. We examined the extent to which age at diagnosis was associated with adjuvant chemotherapy usage, and we adjusted for potential confounding based on differences in other patient characteristics with the use of multiple logistic regression. All P values were two-sided. RESULTS Age at diagnosis was the strongest determinant of chemotherapy: 78% of patients aged 65-69 years, 74% of those aged 70-74 years, 58% of those aged 75-79 years, 34% of those aged 80-84 years, and 11% of those aged 85-89 years received postoperative chemotherapy. The age trend remained pronounced after adjustment for potential confounding based on variation in patients' demographic and clinical characteristics and after exclusion of patients with any evident comorbidity (all P values <.001). CONCLUSIONS Adjuvant chemotherapy for stage III colon cancer is used extensively, especially for patients under the age of 75 years. However, treatment rates decline dramatically with chronologic age. Because patients in their 70s and even 80s have a reasonable life expectancy, further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding this potentially curative treatment. |
| Starting Page | 845 |
| Ending Page | 848 |
| Page Count | 4 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/jnci/93/11/10.1093_jnci_93.11.850/1/850.pdf?Expires=1491622596&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q&Signature=ZX7wXYhPjc1kiMgS5bZ~DzzKmu5wk5o8emSuiLAN9fGz8Co75EGdjljV2PVFfRnDFS152HVdiwTbDwKI6mPoYpDaGT32m6wGkuO4hLPoAu8LvHi4YSN9HqHxIEOr-5RNYnPtNeARlmMOghdsv5ShMHIfCVbEPpADM9SaC2AGfB5b1qcuIBx5tERfh6iGlMGzi5B4lXNb0mdlzXJ3TMmxRXdDwmK6PUzYlafSXl0V4o40kvRQy5HajdRZBtyPQsSLlV1cPKMyZ2yjQFud4jWzvNu3cudG4YAwtJPH-Ph1GcjzrrzATeI~4rlnEEQQYseFZ0taTQbInjs6oNBsr-R1Fw__ |
| PubMed reference number | 11390534v1 |
| Volume Number | 93 |
| Issue Number | 11 |
| Journal | Journal of the National Cancer Institute |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Antineoplastic Chemotherapy Protocols Chemotherapy, Adjuvant Colon Carcinoma Colonic Neoplasms Eighty Nine Excision Exclusion Fluorouracil Medicare Menopause Patients Pharmaceutical Adjuvants Seventy Nine Sixty Nine Stage level 3 |
| Content Type | Text |
| Resource Type | Article |
