Adjuvant Chemotherapy in Older Patients With Stage III Colon Cancer: An Underused Lifesaving Treatment

Muss, Hyman B.; Bynum, Debra L.

doi:10.1200/jco.2012.42.3780

Cited by 22 publications

(14 citation statements)

References 19 publications

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“…Whether or not to use chemotherapy for elderly patients presents a common and substantial challenge. Two retrospective analyses from Surveillance, Epidemiology, and End Results (SEER)-Medicare Database found a survival benefit with chemotherapy for elderly patients252627. However, the benefit for elderly patients from chemotherapy came at the cost of increased toxicity, particularly paresthesias, bone marrow toxicity, and gastrointestinal toxicity1228.…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

Han

et al. 2016

Sci Rep

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Adjuvant chemotherapy is considered the standard of care for patients with colorectal cancer after curative resection. Although current guidelines provide clear instructions for chemotherapy for stage II high-risk and stage III colorectal cancer, it is insufficient to individualize therapy. We analyzed the outcomes of 902 patients with colorectal cancer treated with or without chemotherapy in our hospital. We found Chinese survival benefit for chemotherapy was consistent with current guidelines. Moreover, our data added to the evidence that chemotherapy might be used for elderly patients with stage II high-risk colorectal cancer. Pathological markers could predict response to individualize therapy in a convenient, fast and inexpensive way. We compared survivals of patients with stage II high-risk and stage III colorectal cancer with chemotherapy in different pathological markers expression, and furthermore used 458 colon adenocarcinoma samples from The Cancer Genome Atlas to verify our preliminary results. We confirmed TOPIIα, EGFR and P170 may be sufficiently predictive markers to individualize chemotherapy. FOLFOX was the optimal adjuvant chemotherapy for patients with stage II high-risk and stage III colorectal cancer when TOPIIα was positive or EGFR or P170 was negative.

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Section: Discussionmentioning

confidence: 99%

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

Han

et al. 2016

Sci Rep

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“…Older patients have less access to curative surgery for gynecologic surgery [35], to appropriate adjuvant therapy for colon cancer [36] and to appropriate rehabilitation therapies after myocardial infarction [37]. Elderly patients with head trauma are noted to take longer to get CT head imaging and are less likely to be transferred for neurosurgical care compared to younger patients [38].…”

Section: Discussionmentioning

confidence: 99%

Insurance Status Is Associated with Treatment Allocation and Outcomes after Subarachnoid Hemorrhage

et al. 2014

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ObjectiveSubarachnoid hemorrhage (SAH) is a particularly devastating type of stroke which is responsible for one third of all stroke-related years of potential life lost before age 65. Surgical treatment has been shown to decrease both morbidity and mortality after subarachnoid hemorrhage. We hypothesized that payer status other than private insurance is associated with lower allocation to surgical treatment for patients with SAH and worse outcomes.DesignWe examined the association between insurance type and surgical treatment allocation and outcomes for patients with SAH while adjusting for a wide range of patient and hospital factors. We analyzed the Nationwide Inpatient Sample hospital discharge database using survey procedures to produce weighted estimates representative of the United States population.PatientsWe studied 21047 discharges, representing a weighted estimate of 102595 patients age 18 and above with a discharge diagnosis of SAH between 2003 and 2008.MeasurementsMultivariable logistic and generalized linear regression analyses were used to assess for any associations between insurance status and surgery allocation and outcomes.Main ResultsDespite the benefits of surgery 66% of SAH patients did not undergo surgical treatment to prevent rebleeding. Mortality was more than twice as likely for patients with no surgical treatment compared to those who received surgery. Medicare patients were significantly less likely to receive surgical treatment.ConclusionsNearly two thirds of patients with SAH don't receive operative care, and Medicare patients were significantly less likely to receive surgical treatment than other patients. Bias against the elderly and those with chronic illness and disability may play a part in these findings. A system of regionalized care for patients presenting with SAH may reduce disparities and improve appropriate allocation to surgical care and deserves prospective study.

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“…Beachtenswert sind die sehr geringen Raten an adjuvanten Therapien bei älteren Patienten nach Resektion eines KRK bei 43% der 80-bis 84-Jährigen und 14% der über 85-Jährigen in dieser US-amerikanischen Untersuchung. Diesbezüglich sollte dringend ein Umdenken erfolgen [21].…”

Section: Adjuvante Therapie Von Frühen Oder Lokal Fortgeschrittenen Sunclassified

Kolorektales Karzinom beim alten Patienten

et al. 2015

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Adjuvant Chemotherapy in Older Patients With Stage III Colon Cancer: An Underused Lifesaving Treatment

Cited by 22 publications

References 19 publications

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

A comparative analysis and guidance for individualized chemotherapy of stage II and III colorectal cancer patients based on pathological markers

Insurance Status Is Associated with Treatment Allocation and Outcomes after Subarachnoid Hemorrhage

Kolorektales Karzinom beim alten Patienten

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