Referral Patterns and Adjuvant Chemotherapy Use in Patients With Stage II Colon Cancer

Kirkpatrick, Haskell; Aitelli, Cristi L.; Qin, Haili; Becerra, Carlos; Lichliter, Warren E.; McCollum, A. David

doi:10.3816/ccc.2010.n.020

Cited by 19 publications

(12 citation statements)

References 22 publications

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“…Various reasons contribute to this improvement in prognostic outcome including optimization of chemo‐ and radiation therapy as well as therapy adjustments. The most important factors hereby are age, tumor stage, comorbidities, and diagnosis year 4‐8 . As a result, patients with CRC survive substantially longer.…”

Section: Introductionmentioning

confidence: 99%

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Zhang

et al. 2020

Cancer Medicine

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Background Colorectal cancer (CRC) treatment and patient survival improved greatly. Consequently an increased incidence of non‐cancer‐related deaths is observed. This study analyzed the causes of non‐cancer death for people suffering from CRC based on the year of diagnosis, follow‐up time, and patient's age. Methods The data from patients diagnosed with CRC in the years 2000–2016 were taken from the Surveillance, Epidemiology, and End Results 18 database. Patients were categorized according to: death from CRC, non‐CRC cancer, and non‐cancer. Constituent ratios and standardized mortality ratios (SMRs) were calculated to describe the death causes distribution and relative death risks. Results Between 2000 and 2016, a stable and rapid drop for the original diagnosis as death cause for CRC patients was observed (70.19% to 49.35%). This was coupled to an increase in non‐cancer‐associated death reasons (23.38% to 40.00%). The most common non‐cancer death cause was heart disease, especially for elderly patients. However, deaths from accidents and adverse effects were frequent in younger CRC patients. Patients died from septicemia more often within the first follow‐up year; however, a 6‐fold increase in death from Alzheimer's disease was found for after at least 180 months follow‐up time. The SMRs of all 25 non‐cancer death causes initially decreased in all CRC subgroups, followed by an increase with follow‐up times. Gradually decreasing SMR values were observed with increasing age of CRC patients. Conclusions These findings could help modify and sharpen preventive measures and clinical management and raise physician's awareness to potential non‐CRC death risk factors for CRC patients.

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Section: Introductionmentioning

confidence: 99%

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Zhang

et al. 2020

Cancer Medicine

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“…9 Nevertheless, a considerable proportion of patients are still receiving this treatment. 20,23 It is possible that chemotherapy is overused in clinical practice without substantial gain in survival.…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy Use and Survival Among Young and Middle-Aged Patients With Colon Cancer

et al. 2017

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Importance Treatment options for young-onset colon cancer patients remain to be defined and their effects on prognosis are unclear. Objective To investigate receipt of adjuvant chemotherapy by age category (18-49, 50-64, and 65-75) and assess if age differences in chemotherapy matched survival gains among patients diagnosed with colon cancer in an equal access healthcare system. Design A cohort study was conducted based on cancer registry and administrative medical claims data. Setting This study was based on linked and consolidated data from the U.S. Department of Defense’s Central Cancer Registry and Military Heath System medical claims databases. Participants Participants were 3,143 patients ages 18 to 75 with histologically confirmed primary colon adenocarcinoma diagnosed between 1998 and 2007. Exposures Patients who underwent surgery and postoperative systemic chemotherapy. Main Outcomes and Measures The primary outcome measure of the study was overall survival of patients who only received surgery and those who received both surgery and post-operative systemic chemotherapy. Results Young and middle aged patients were two to eight times more likely to receive postoperative systemic chemotherapy as compared to older patients, across all tumor stages. Middle-aged patients with stage I (OR 5.04, 95% CI 2.30-11.05) and II (OR 2.42, 95% CI 1.58-3.72) disease were more likely to receive postoperative chemotherapy as compared to older patients. Both groups were two and a half times more likely to receive multi-agent chemotherapy than older patients. Among patients who received surgery and post-operative systemic chemotherapy, no significant differences were observed in survival between age groups. Conclusions and Relevance In an equal access healthcare system, we found potential overuse of chemotherapy among young and middle-aged adults with colon cancer. The addition of postoperative systemic chemotherapy did not result in matched survival improvement.

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“…Referral patterns for patients with HCC depended not only on the extent of disease but also on demographic factors including age and race. Given that specialist consultation and subsequent receipt of treatment has been correlated in other cancer types, 29,30 data on referral patterns from the current study may help explain some variations in treatment among patients with HCC.…”

Section: Discussionmentioning

confidence: 83%

Patterns of Consultation and Treatment of Patients with Hepatocellular Carcinoma Presenting to a Large Academic Medical Center in the US

Stacy

Hyder

Cosgrove

et al. 2013

Journal of Gastrointestinal Surgery

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Background Management of hepatocellular carcinoma (HCC) often involves many subspecialist providers, as well as a broad range of treatment options. This study sought to evaluate referral and treatment patterns among patients with HCC at a large academic medical center. Methods Data from our cancer registry between 2003–2011 were abstracted on 394 patients who were primarily diagnosed/treated for HCC at Johns Hopkins Hospital (JHH); data on patients who were diagnosed/treated with HCC elsewhere and who received secondary treatment at JHH (n=391) were also abstracted for comparison purposes. Results Among the main cohort, the most common specialties to be consulted were surgery (n=225, 57.1 %), gastroenterology (n=225, 57.1 %), and interventional radiologist (n=206, 52.3 %), while only 96 (24.4 %) were referred to medical oncology. Factors associated with surgical consultation included younger age (odds ratio (OR) 3.35, 95 % CI 1.62–6.92), tumor size <5 cm (OR 1.82, 1.09–3.02), and unilobar disease (OR 2.94, 1.31–6.59) (all P<0.05). Patients initially diagnosed/treated elsewhere had larger tumors (4 vs. 6 cm), bilateral disease (19.2 vs. 26.8 %), and were more likely to be seen by interventional radiology (all P<0.05) Conclusions Most patients were seen by surgeons, gastroenterologists, or interventional radiologists, with only a minority being seen by medical oncologists. Referral patterns depended on patient-level factors, as well as extent of disease.

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Referral Patterns and Adjuvant Chemotherapy Use in Patients With Stage II Colon Cancer

Cited by 19 publications

References 22 publications

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Analyzing non‐cancer causes of death of colorectal carcinoma patients in the US population for the years 2000–2016

Chemotherapy Use and Survival Among Young and Middle-Aged Patients With Colon Cancer

Patterns of Consultation and Treatment of Patients with Hepatocellular Carcinoma Presenting to a Large Academic Medical Center in the US

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