Background: Given the paucity of information on dose intensity, the objective of this study is to describe the use of adjuvant chemotherapy for stage III colon cancer, focusing on relative dose intensity (RDI), overall survival (OS) and disease-free survival (DFS).
Methods: Retrospective cohort of 367 patients diagnosed with stage III colon cancer in 2003-2008 and treated at 19 VA medical centers. Kaplan-Meier curves summarize 5-year OS and 3-year DFS by chemotherapy regimen and RDI, and multivariable Cox proportional hazards regression was used to model these associations.
Results: 5-fluorouracil/leucovorin (FU/LV) was the most commonly initiated regimen in 2003 (94.4%) and 2004 (62.7%); in 2005-2008, a majority of patients (60%-74%) was started on an oxaliplatin-based regimen. Median RDI was 82.3%. Receipt of >70% RDI was associated with better 5-year OS (p < 0.001) and 3-year DFS (P = 0.009) than was receipt of ≤70% RDI, with 5-year OS rates of 66.3% and 50.5%, respectively and 3-year DFS rates of 66.1% and 52.7%, respectively. In the multivariable analysis of 5-year OS, oxaliplatin + 5-FU/LV (versus 5-FU/LV) (HR = 0.55; 95% CI = 0.34-0.91), >70% RDI at the first year (HR = 0.58; 95% CI = 0.37-0.89) and married status (HR = 0.66; 95% CI = 0.45-0.97) were associated with significantly decreased risk of death, while age ≥75 (versus 55-64) (HR = 2.06; 95% CI = 1.25-3.40), Charlson Comorbidity Index (HR = 1.17; 95% CI = 1.06-1.30), T4 tumor status (versus T1/T2) (HR = 5.88; 95% CI = 2.69-12.9), N2 node status (HR = 1.68; 95% CI = 1.12-2.50) and bowel obstruction (HR = 2.32, 95% CI = 1.36-3.95) were associated with significantly increased risk. Similar associations were observed for DFS.
Conclusion: Patients with stage III colon cancer who received >70% RDI had improved 5-year OS. The association between RDI and survival needs to be examined in studies of adjuvant chemotherapy for colon cancer outside of the VA.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352567 | PMC |
| http://dx.doi.org/10.1186/s12885-015-1038-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
tumour specific surgery in colon cancer is gaining popularity among colorectal surgeons. Many advocate adapting surgical technique based on preoperative CT staging as not all patients require complete mesocolic excision (CME) and D3 lymphadenectomy. We aimed to assess the sensitivity and specificity of preoperative CT scans in nodal staging and analyse whether inadequate CT staging could have influenced local recurrences.
View Article and Find Full Text PDFTargeting the Ajuba/Notch axis increases the sensitivity of colon cancer cells to 5-fluorouracil.
Cytojournal
November 2024
The First Clinical Medical College, Jinan University, Guangzhou, China.
Objective: Colorectal cancer is severely challenging because of the insufficient understanding of the mechanism underlying its resistance to clinical chemotherapy. The purpose of our study is to investigate the role of the LIM protein Ajuba (JUB) in the chemoresistance of colon cancer and its potential effect on clinical treatment.
Material And Methods: The protein levels of JUB in colon cancer tissues were evaluated using Western blot analysis and immunohistochemistry assays.
Optimizing Urgent Suspected Colon Cancer Referrals and Reducing Colonoscopy Wait Times in Wales.
Cureus
December 2024
General Surgery, Aneurin Bevan University Health Board, Newport, GBR.
Aim: To assess recent colonoscopies and CT scans in conjunction with the feacal immunochemical test (FIT) for possibly downgrading urgent suspected cancer (USC) referrals.
Methods: A retrospective single-centre study was conducted, including all USC referrals for colonoscopy in 2022, excluding anal cancers. The CT and colonoscopy findings for a two-year period prior to the referral, along with the FIT result (if done), were noted.
Pediatric and adolescent cancer disparities in the Middle East and North Africa (MENA) region: incidence, mortality, and survival across socioeconomic strata.
BMC Public Health
December 2024
Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
Background: Cancer is one of the leading causes of death in children and adolescents, with a significant concentration in low and middle-income countries. Previous research has identified disparities in cancer incidence and mortality based on a country's level of development. The Middle East and North Africa (MENA) region comprises of countries with heterogeneous income and development levels.
View Article and Find Full Text PDFKnowledge and attitudes of primary care physicians regarding acromegaly: a survey study with multinational participation.
BMC Prim Care
December 2024
Department of Internal Medicine, Division of Endocrinology and Metabolism, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey.
Background: Acromegaly is a disease with high morbidity and mortality rates. The role of primary care physicians is very important in the early diagnosis of acromegaly. The present study aims to determine the knowledge and attitudes of primary care physicians about acromegaly in different countries worldwide.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!