Treatment Patterns and Outcomes of Patients with Gastric Cancer in the Us: A Retrospective Analysis of Electronic Medical Record (EMR) Data

4086 Background: Gastric cancer is the second most common gastrointestinal cancer in our hospital based cancer registry. This retrospective analysis aims at studying the epidemiology and treatment patterns for gastric cancer at our hospital, which is a tertiary care cancer center for the state of Andhra Pradesh in south India. Methods: A retrospective analysis of the case records of 125 consecutive patients with gastric cancer who presented to our department between Jan 2004 and Dec 2005 were analysed. Data regarding epidemiology, stages at diagnosis and treatment plans were collected. Patients with early gastric cancer received 5FU based chemoradiation or chemotherapy only. Palliative chemotherapy included 5FU/cisplatin based regimens. Results: A total of 125 patients were analysed. The median age was 61years (range 18–82 years). 71% were males and 29% females. Being a tertiary care center, 92% were referred with a confirmed diagnosis on endoscopic biopsy. 30% were smokers, 11% consumed alcohol, 40% had both habits while 29% had neither. The most common part of the stomach involved was the antro-pyloric region (44%) followed by the body (30%), GE junction/cardia (20%) while 6% had diffuse involvement including linitis plastica. At diagnosis, 35% were early stage, 56% metastatic and 8% locally advanced tumors. 90% patients who had surgery for early stage disease had T2,3 tumors. One third had inadequate nodal staging.70% of patients who had curative resections underwent adjuvant chemoradiation and 30% had chemotherapy only. Of all patients with metastatic disease, 65% palliative chemotherapy while 45% opted for best supportive care. Conclusions: The distribution of tumors within the stomach is similar to Japanese data, which may reflect the common etiological factors like high salt diet. The fact that one third of patients had inadequate nodal dissection stresses the relevance of adjuvant chamoradiotherapy protocols. The high incidence of smoking as a contributory factor in the etiology reflects the need for aggressive anti tobacco legislation. The study reiterates the need for inexpensive and novel therapies for palliation of symptoms in patients with advanced disease and widens the scope for collaborative clinical trials. No significant financial relationships to disclose.

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Assessment of Epoetin Alfa in Patients with Myelodysplastic Syndrome Utilizing an Electronic Medical Record Database.

Blood ◽

10.1182/blood.v110.11.5180.5180 ◽

2007 ◽

Vol 110 (11) ◽

pp. 5180-5180

Author(s):

Bruce Feinberg ◽

James Gilmore ◽

Carlos Franco ◽

Tom Gondesen

Keyword(s):

Myelodysplastic Syndrome ◽

Medical Record ◽

Clinical Outcomes ◽

Electronic Medical Record ◽

Real World ◽

Treatment Patterns ◽

Continuous Treatment ◽

Epoetin Alfa ◽

Treatment Episode ◽

The Mean

Abstract BACKGROUND: There are limited data from electronic medical record studies that provide a real-world view of practice patterns of epoetin alfa (EPO) as supportive therapy in patients with myelodysplastic syndrome (MDS). This retrospective, observational study was conducted to gain a better understanding of the demographics, real-world treatment patterns, and clinical outcomes for patients with MDS receiving EPO. METHODS: Electronic medical record data from a large oncology/hematology practice in the southeastern United States were collected from January 1, 2005 to September 30, 2006. Inclusion criteria consisted of patients receiving ≥ 2 doses of EPO with a diagnosis of MDS within 30 days prior to or during EPO treatment episode. All other cancer diagnoses were excluded. Baseline characteristics, EPO dosing, change in Hb levels, and response to EPO (attainment of Hb ≥ 11.0 g/dL at any point during the treatment episode from a baseline Hb < 11g.dL) were measured. EPO treatment episode was defined as continuous treatment with EPO and without EPO administration 35 days prior to or after the last administration. Weekly (QW) dosing was defined as ≤ 9 days, every 2 week dosing (Q2W) was defined as 9.1–18.0 days, and every 3 weeks (Q3W) was defined as > 18.1 days. RESULTS: A total of 166 patients were included in the analysis; 63.9% women, mean age was 76.2 ± 11.3 years. The mean starting dose was 44,518 ± 11,258 units (median = 40,000 units), and the mean administered dose (any dose of EPO) was 45,587 ± 10,351 units (median=40,000 units). The mean cumulative dose (sum of all EPO doses during the treatment episode) was 312,349 ± 453,551 units. Weekly dosing was administered in 38.0% of patients while 34.9% of patients received Q2W dosing and 27.1% received Q3W dosing. Mean Hb at baseline was 10.6 ± 1.1 mg/dL and increased to 11.3 ± 1.7 mg/dL after 12 weeks of EPO therapy. Fifty percent of the patients responded to treatment and the mean time to response was 33.2 days. DISCUSSION: This study provides insight into real-world treatment patterns and clinical outcomes for patients with MDS treated with EPO. Additional real-world studies may be warranted to validate these findings.

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