Association of delayed commencement of adjuvant chemotherapy (AC) with inferior survival in colon cancer patients with stage II and III diseases: A national population-based cohort study.

669 Background: To evaluate factors affecting the delay ( ≥ 8 weeks) of AC and the impact of chemotherapy delay on survival in patients with colon cancer(CC). Methods: The study cohort consisted of patients with stage II and III colon cancer, diagnosed between January 1, 2011 and December 31, 2012, who underwent curative resection and AC at all hospitals registered in the Korean Health Insurance Review and Assessment Service (HIRA). Detailed clinical data are from monitoring and evaluation of quality of colon cancer care. Results: Among 5355 patients, 154 (2.9%) received AC more than 8 weeks after surgery. Based on multivariate analysis, risk factors associated with AC delay ≥ 8 weeks were: older age [65 to 74 years (hazard ratio, HR = 1.48) and 75 years (HR = 1.69), p = 0.0354], medical aid status in health security system (HR = 1.76, p = 0.0345), emergency surgery (HR = 2.43, p = 0.0002), and chemotherapy with fluoropyrimidine (HR = 1.49, p = 0.0373). Independent prognostic factors for inferior OS included AC delay ≥ 8 weeks (HR = 1.49, p = 0.0365), older age [65 to 74 years (HR = 1.94) and 75 years (HR = 3.41), p < 0.0001], TNM III stage (HR = 2.46, p < 0.0001), emergency surgery (HR = 1.89, p < 0.0001), ASA score with 3 or higher (HR = 1.50, p < 0.0001), and higher transfusion amount (HR = 1.09, p = 0.0392). OS rates in patients with stage II / III CCs according to delay of AC using 8 weeks cutoff showed inferior OS in the delayed chemotherapy group (p = 0.008).Detailed OS rates were 97.81% at 1 year, 93.77% at 2 year, 89.62% at 3 year, and 85.79% at 4 year in the chemotherapy group within 8weeks. In the delayed chemotherapy group ≥ 8 weeks, OS rates were 96.1% at 1 year, 87.66% at 2 year, 80.98% at 3 year, and 80.2% at 4 year. Conclusions: This national population-based cohort study shows that delayed commencement of AC, defined as ≥ 8 weeks, is associated with inferior OS in CC patients with stage II / III. To reduce the proportion of patients receiving delayed AC, multidimensional aspects such as health insurance status or age should be considered. Based on our results, the time of commencement of chemotherapy can be incorporated as another quality indicator for colon cancer care.

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Can AI technology augment tumor board treatment decisions for stage II colon cancer care?

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.15_suppl.e18582 ◽

2018 ◽

Vol 36 (15_suppl) ◽

pp. e18582-e18582 ◽

Cited By ~ 1

Author(s):

Peng-ju Chen ◽

Ting-ting Sun ◽

Tian-le Li ◽

Irene Dankwa-Mullan ◽

Alexandra Urman ◽

...

Keyword(s):

Colon Cancer ◽

Cancer Care ◽

Treatment Decisions ◽

Stage Ii ◽

Tumor Board ◽

Stage Ii Colon Cancer ◽

Colon Cancer Care

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Colon Cancer Sidedness, Presentation, and Survival at Different Stages

Journal of Oncology ◽

10.1155/2019/4315032 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12 ◽

Cited By ~ 7

Author(s):

Mark B. Ulanja ◽

Mohit Rishi ◽

Bryce D. Beutler ◽

Mokshya Sharma ◽

Darryll R. Patterson ◽

...

Keyword(s):

Colon Cancer ◽

Overall Survival ◽

Cohort Study ◽

Stage Iv ◽

Population Based ◽

Stage I ◽

Stage Ii ◽

Cox Proportional Hazard ◽

Using Data ◽

The Relationship

Background. Several prognostic factors have been used to guide therapy for colon cancer (CC). However, the relationship between CC laterality (sidedness) and prognosis remains under investigation. Objectives. To assess the effect of laterality on CC presentation and survival, using a Surveillance, Epidemiology, and End Results (SEER) population-based cohort. Methods. A retrospective cohort study using data from the SEER program (2007-2015). Results. Of the 163,980 patients with CC, 85,779 (52.3%) presented with right-sided CC (RCC) and 78,201 (47.7%) with left-sided CC (LCC). Stage distributions were as follows: stage I, 24.1%; stage II, 27.3%; stage III, 28.2%; and stage IV, 20.4%. In an adjusted modified Poisson regression approach for risk ratio (RR), patients with LCCs were more likely to be male (RR = 1.14; 95% CI 1.12-1.15, p<0.001). As compared to stage I, stage II cancers (RR = 0.88, 95% CI 0.87-0.90, p<0.001) were less likely to be LCC. Stage IV CC was slightly less likely to be left-sided (RR = 0.98, 95% CI 0.98, 0.96-1.00, p = 0.028). The median overall survival (OS) for RCC was 87 months. The median OS for LCC was not established, as more than half of the patients diagnosed with LCC were still living at the time of the analysis. In adjusted Cox proportional Hazard model, individuals with stage I, III, and IV LCCs had superior OS as compared to those with matched-stage RCC (adjusted HR = 0.87; 95% CI 0.85-0.88, p<0.001). However, OS was worse among those with stage II disease who presented with LCC (adjusted Hazard ratio [aHR] = 1.06; 95% CI 1.02-1.11, p = 0.004). CC-specific survival (CSS) was superior for LCC versus RCC for stages III and IV but worse for II. Conclusions. In this population-cohort study, LCC is associated with superior OS and CSS survival. The overall survival advantage was attributed to stage I, III, and IV disease. Individuals presenting with stage II disease exhibit superior survival if the CC is right-sided.

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The impact of delayed commencement of adjuvant chemotherapy (eight or more weeks) on survival in stage II and III colon cancer: a national population-based cohort study

Oncotarget ◽

10.18632/oncotarget.17767 ◽

2017 ◽

Vol 8 (45) ◽

pp. 80061-80072 ◽

Cited By ~ 6

Author(s):

Young Wan Kim ◽

Eun Hee Choi ◽

Bo Ra Kim ◽

Woo-Ah Ko ◽

Yeong-Mee Do ◽

...

Keyword(s):

Colon Cancer ◽

Cohort Study ◽

Adjuvant Chemotherapy ◽

Population Based ◽

Stage Ii ◽

National Population ◽

The Impact

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Associations of P Score With Real-World Survival Improvement Offered by Adjuvant Chemotherapy in Stage II Colon Cancer: A Large Population-Based Longitudinal Cohort Study

Frontiers in Oncology ◽

10.3389/fonc.2021.574772 ◽

2021 ◽

Vol 11 ◽

Author(s):

Qi Liu ◽

Zezhi Shan ◽

Dakui Luo ◽

Sheng Zhang ◽

Qingguo Li ◽

...

Keyword(s):

Colon Cancer ◽

Cohort Study ◽

Adjuvant Chemotherapy ◽

Survival Benefit ◽

Large Population ◽

Tumor Biology ◽

Patient Characteristics ◽

Population Based ◽

Stage Ii ◽

Stage Ii Colon Cancer

BackgroundBased on a prognostic scoring system (P score) proposed by us recently, this retrospective large population-based and propensity score-matched (PSM) study focused on predicting the survival benefit of adjuvant CT in stage II disease.MethodsPatients diagnosed with stage II colon cancer (N = 73397) were identified from the Surveillance, Epidemiology, and End Results database between January 1, 1988 and December 31, 2005 and divided into the CT and non-CT groups. PSM balanced the patient characteristics between the CT and non-CT groups.ResultsThe magnitude of CSS improvement among patients treated with adjuvant CT was significantly associated with the P score, score 8 [hazard ratio (HR) = 0.580, 95% confidence interval (CI) = 0.323–1.040, P = 0.067] was associated with a much higher increased CSS benefit among patients treated with adjuvant CT as compared to score 2* (*, including scores 0, 1, and 2; HR = 1.338, 95% CI = 1.089–1.644, P = 0.006).ConclusionsHigh P scores were demonstrated to be associated with superior survival benefit of adjuvant CT. Therapy decisions of adjuvant CT in stage II colon cancer could be tailored on the basis of tumor biology, patient characteristics and the P score.

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Routine Versus Risk-Based HIV Testing and Mortality of Patients With HIV Under National Health Insurance: A Population-Based Cohort Study

SSRN Electronic Journal ◽

10.2139/ssrn.3731442 ◽

2020 ◽

Author(s):

Yi-Hsuan Chen ◽

Chi-Tai Fang ◽

Ming-Chieh Shih ◽

Kuan-Yin Lin ◽

Shu-Sen Chang ◽

...

Keyword(s):

Cohort Study ◽

Health Insurance ◽

Hiv Testing ◽

National Health Insurance ◽

National Health ◽

Population Based ◽

Versus Risk

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Ethnic differences in colon cancer care in the Netherlands: a nationwide registry-based study

BMC Cancer ◽

10.1186/s12885-017-3241-5 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

M. Lamkaddem ◽

M. A. G. Elferink ◽

M. C. Seeleman ◽

E. Dekker ◽

C. J. A. Punt ◽

...

Keyword(s):

Colon Cancer ◽

The Netherlands ◽

Ethnic Differences ◽

Cancer Care ◽

Nationwide Registry ◽

Colon Cancer Care

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Risk of primary gastrointestinal cancers following incident non-metastatic breast cancer: a Danish population-based cohort study

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000413 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000413

Author(s):

Kasper Adelborg ◽

Dóra Körmendiné Farkas ◽

Jens Sundbøll ◽

Lidia Schapira ◽

Suzanne Tamang ◽

...

Keyword(s):

Breast Cancer ◽

Colon Cancer ◽

Cohort Study ◽

Metastatic Breast Cancer ◽

Stomach Cancer ◽

Metastatic Breast ◽

Population Based ◽

Gastrointestinal Cancers ◽

Increased Risk

ObjectiveWe examined the risk of primary gastrointestinal cancers in women with breast cancer and compared this risk with that of the general population.DesignUsing population-based Danish registries, we conducted a cohort study of women with incident non-metastatic breast cancer (1990–2017). We computed cumulative cancer incidences and standardised incidence ratios (SIRs).ResultsAmong 84 972 patients with breast cancer, we observed 2340 gastrointestinal cancers. After 20 years of follow-up, the cumulative incidence of gastrointestinal cancers was 4%, driven mainly by colon cancers. Only risk of stomach cancer was continually increased beyond 1 year following breast cancer. The SIR for colon cancer was neutral during 2–5 years of follow-up and approximately 1.2-fold increased thereafter. For cancer of the oesophagus, the SIR was increased only during 6–10 years. There was a weak association with pancreas cancer beyond 10 years. Between 1990–2006 and 2007–2017, the 1–10 years SIR estimate decreased and reached unity for upper gastrointestinal cancers (oesophagus, stomach, and small intestine). For lower gastrointestinal cancers (colon, rectum, and anal canal), the SIR estimate was increased only after 2007. No temporal effects were observed for the remaining gastrointestinal cancers. Treatment effects were negligible.ConclusionBreast cancer survivors were at increased risk of oesophagus and stomach cancer, but only before 2007. The risk of colon cancer was increased, but only after 2007.

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