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The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.
- Source :
-
PloS one [PLoS One] 2014 Sep 19; Vol. 9 (9), pp. e107993. Date of Electronic Publication: 2014 Sep 19 (Print Publication: 2014). - Publication Year :
- 2014
-
Abstract
- Background: Delayed chemotherapy is associated with inferior survival in stage III colon and stage II/III rectal cancer patients, but similar studies have not been performed in stage II colon cancer patients. We investigate the association between delayed and incomplete chemotherapy, and the association of delayed chemotherapy with survival in stage II colon cancer patients.<br />Patients and Methods: Patients (age ≥ 66) diagnosed as stage II colon cancer and received chemotherapy from 1992 to 2005 were identified from the linked SEER-Medicare database. The association between delayed and incomplete chemotherapy was assessed using unconditional and conditional logistic regressions. Survival outcomes were assessed using stratified Cox regression based on propensity score matched samples.<br />Results: 4,209 stage II colon cancer patients were included, of whom 73.0% had chemotherapy initiated timely (≤ 2 months after surgery), 14.7% had chemotherapy initiated with moderate delay (2-3 months), and 12.3% had delayed chemotherapy (≥ 3 months). Delayed chemotherapy was associated with not completing chemotherapy (adjusted odds ratio (OR): 1.33 (95% confidence interval: 1.11, 1.59) for moderately delayed group, adjusted OR: 2.60 (2.09, 3.24) for delayed group). Delayed chemotherapy was associated with worse survival outcomes (hazard ratio (HR): 1.75 (1.29, 2.37) for overall survival; HR: 4.23 (2.19, 8.20) for cancer-specific survival).<br />Conclusion: Although the benefit of chemotherapy is unclear in stage II colon cancer patients, delay in initiation of chemotherapy is associated with an incomplete chemotherapy course and poorer survival, especially cancer-specific survival. Causal inference in the association between delayed initiation of chemotherapy and inferior survival requires further investigation.
- Subjects :
- Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Colonic Neoplasms mortality
Colonic Neoplasms pathology
Female
Humans
Logistic Models
Male
Neoplasm Staging
Odds Ratio
Retrospective Studies
Risk Factors
Time Factors
United States
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Colonic Neoplasms drug therapy
Kaplan-Meier Estimate
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 9
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 25238395
- Full Text :
- https://doi.org/10.1371/journal.pone.0107993