project to help patients get treatment for cancer (palliative care). In view of this we aimed to find out the factors which influence their late presentation at Hospitals. The World Health Organization (2015) has reported that cancer is the second most common cause of death and was responsible for over 25000 deaths in 2015, approximately 80% occurring in developing countries. It was projected that thiswill increase by 25% over the next 10 years if nothing is done such as putting adequate screening, treatment and prevention measures in place. Methods: The study took place across the three sites of Hospice Africa Uganda. It has cared for about 70500 patients of which 55300 are cancer patients. A qualitative study was used to interview the patients so as to get a deep understanding of the reasons why patients with cancer present late for treatment at regional hospitals and national referral hospitals. Using the semi structured questionnaire guided the interviewers because it helped the patients to discuss freely the reasons why they report late. Then, data was transcribed and analyzed. A report was written and shared with the team of Hospice Africa Uganda across the three branches. These patients were interviewed at the three sites of hospice because come for the palliative care and during the outreach only patients with cancer were elegible for the study. The researchers used local language during the interviews since the majority of patients are more fluent in local language than English. A recording tape was used to store all the discussions for flexibility. Results: Of theses patients, 68.5% did not have financial support to carry out early investigation, were peasant farmers, with little knowledge of cancer,17.9% had the financial support but were lazy to go to the hospital for checkup.14.3% did not give clear reason, while others were coming far away from the health units. Conclusions: There is a very big role for the government, and health workers to sensitize the public, set up more health facilities and train more healthcare workers.
differences between right and left colon cancer. In India there are few studies on the comparison of left versus right colon cancer. As there is scant published literature we want to study the clinicopathological features and outcome differences in right versus left colon cancers. Methods: A total of 298 patients were studied. Among them 94 patients have stage IV disease. Remaining 204 patients have stage I,II,III disease.We evaluauted age,sex,site of the tumor,size of the lesion,nodal status,grade,lymphovascular invasion(LVI), perineural invasion(PNI),histology of the tumor,any presentation with obstruction or perforation,disease free survival(DFS) of stage I,II,III colon cancer pateints who had completed the surgery and who received at least 6 cycles of chemotherapy. Results: Out of 204 patients 109(54.43%) had right sided colon cancer and 95(46.57%) patients had left sided colon cancer.The median age of left and right colon cancer patients is 55(18-82),50(20-82) respectively.The male: female ratio is 2.18:1.Right sided colon cancer patients presented with statistically significant large tumor size(<0.0001),poorly differentiated histology(<0.0001),emergency presentation(Obstruction/Perforation).Though there is differnce in DFS between Right colon cancer and left colon cancer after multivariate analysis of DFS of all stage I,II,III patients it is not statistically significant.By stagewise subgroup analysis there is no significant survival diffrence between right and left colon cancer patients in stage II (P ¼ 0.5).But there is statistically significant difference in DFS between right and left colon cancer(p ¼ 0.02) in stage III patients. Univariate and multivariate analysis of Stage III colon cancer patients (92/204 patients) Conclusions: Stage III right sided colon cancer patients have statistically significant lower disease free survival when compared to stage III left sided colon cancer patients. Legal entity responsible for the study: Nizams Institute of Medical Sciences Funding: None Disclosure: All authors have declared no conflicts of interest. 173P Increasing disparities in age-related cause specific survival (CSS) among US patients with colorectal cancer: SEER analysis
Background: Randomized clinical trials describe the benefit of chemotherapy for advanced and incurable cancer patients with selected patient and disease characteristics. The overall survival benefits for the whole population with incurable cancer patients in Australia, if evidence-based guidelines for chemotherapy were implemented, are unknown. This study's purpose was to estimate the overall population survival benefit of first-course palliative chemotherapy if guidelines were followed. Methods: Decision trees with evidence-based indications for chemotherapy have been previously defined. Each branch of the tree corresponds to a specific cohort who have, or do not have, defined indication for palliative chemotherapy. Palliative chemotherapy survival benefit was defined as the absolute incremental survival benefit of firstcourse chemotherapy over no chemotherapy (best supportive care), or over palliative chemotherapy for palliative indications. Multiple electronic citation databases were systematically queried, including Medline and Cochrane library. In cases where there were multiple sources of the same level of evidence, then hierarchical meta-analysis was performed. The survival benefits of palliative chemotherapy were estimated for 1-and 5-year. Sensitivity analyses were performed to assess the robustness of our estimates. Results: 36% of survival benefit was attributed to first-course palliative chemotherapy. The 1-year survival benefit of the entire cancer population was mostly contributed by palliative indications. The estimated 1-year and 5-year absolute population-based overall survival benefits of optimally-used first-course chemotherapy for advanced and incurable cancer were 3.6% (95% Confidence Interval, CI, 3.4%-3.7%) and 1.0% (95% CI, 0.9%-1.0%), respectively. Conclusions: First-course chemotherapy prolongs life for advanced and incurable cancer patients at 1-year and 5-years. Chemotherapy provides a modest survival benefit when it is used in accordance with guideline recommendations. It is important to include other relevant quality of life-adjusted endpoints and patient-reported outcomes in future studies in this group of palliative patients.
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