scholarly journals Adjuvant Chemotherapy Use and Adverse Events Among Older Patients With Stage III Colon Cancer

JAMA ◽  
2010 ◽  
Vol 303 (11) ◽  
pp. 1037 ◽  
Author(s):  
Katherine L. Kahn
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Adverse Events ◽  
Older Patients ◽  
Stage Iii ◽  
Stage Iii Colon Cancer

Clinical efficacy and safety of early adjuvant chemotherapy for stage III colon cancer: Short-term outcomes of a multicenter, randomized, open-label, phase 3 trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3598-3598
Author(s):  
Jun Seok Park ◽  
Soo Yeun Park ◽  
Gyu-Seog Choi ◽  
Hye Jin Kim ◽  
Jong Gwang Kim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Adverse Events ◽  
Surgical Complication ◽  
Phase Iii ◽  
Stage Iii ◽  
Survival Outcomes ◽  
Stage Iii Colon Cancer

3598 Background: Adjuvant chemotherapy (AC) is recommended to commence within 8 weeks since after surgical resection of stage II or III colon cancer. Results of many retrospective studies showed inferior survival outcomes following delay of AC delay. Moreover, preclinical studies showed that the progression of disseminated cancer cells is profound during the postoperative period. This study is the first prospective trial to evaluate early (≤ 14 days postoperative) AC for patients (pts) with stage III colon cancer. Methods: This study is a prospective, multicenter, randomized phase III trial. Pts with pathological stage III colon cancer were enrolled and randomized 1:1 to early AC (starting AC ≤ 14 days after surgery) or conventional AC (starting AC > 14 days after surgery). Pts were recommended to receive 12 cycles of FOLFOX-6 for AC. The primary endpoint was disease-free survival. The secondary endpoints were overall survival, adverse events, surgical complication during AC, and patient-reported outcomes (quality of life) during 1 year after surgery. Herein, safety data, chemotherapy delivery, and quality of life are presented. Results: This study randomized 443 pts either early AC arm (221pts) or early AC arm (222 pts) to the during September 2011 to March 2020. 380 pts who received at least one cycle of FOLFOX-6 were included in the safety analysis (192 and 188 in the early and conventional AC arms, respectively). The baseline characteristics of the two groups were well-balanced except for the interval from the surgery to the initial AC. The early and conventional AC arms started their first chemotherapy at median of 13 (4-43 days) and 29 (17-53 days) after surgery (p < 0.001), respectively. No significant differences were seen in the median chemotherapy cycles, AC completion, and relative oxaliplatin dose intensity between groups. AC Completion without any change of dose or schedule delay was seen in 18% and 20% in early and conventional AC arms respectively, while dose reduction or delay was 65% and 61%, respectively. Toxicities of grade 3 or more were seen in 28% in both groups. One patient in the early AC arm underwent an emergent operation for anastomotic leakage on the second day of 5-fluorouracil infusion (postoperative day 14). However, the surgical complication was not seen in any other patient. The scores of the European Organization for Research and Treatment of Cancer Quality of Life core 30 questionnaire were similar in both arms at baseline (before starting AC), and 1 month, 3 months, 6 months, and 12 months after surgery. Conclusions: Early AC was safe and did not increase either chemotherapy-related adverse events or surgery-related complications during treatment. Moreover early AC did not reduce the quality of life of the pts during 1 year after surgery. This study continues to follow-up the patients for survival outcomes. Clinical trial information: NCT01460589.

scholarly journals Effect of adjuvant chemotherapy on survival benefit in stage III colon cancer patients stratified by age: a Japanese real-world cohort study

2019 ◽  
Author(s):  
Hidetaka Kawamura ◽  
Toshitaka Morishima ◽  
Akira Sato ◽  
Michitaka Honda ◽  
Isao Miyashiro
Keyword(s):  
Colon Cancer ◽  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Survival Benefit ◽  
Older Patients ◽  
Age Groups ◽  
Stage Iii ◽  
Younger Patients ◽  
Stage Iii Colon Cancer

Abstract Background: Adjuvant chemotherapy is relatively underused in older patients with colon cancer in Japan, and its age-specific effects on clinical outcomes remain unclear. This study aimed to assess the effect of adjuvant chemotherapy on survival benefit in stage III colon cancer patients stratified by age in a Japanese real-world setting. Methods: In this multi-center retrospective cohort study, we analyzed patient-level information through a record linkage of population-based cancer registry data and administrative claims data. The study population comprised patients aged ≥18 years who received a pathological diagnosis of stage III colon cancer and underwent curative resection between 2010 and 2014 at 36 cancer care hospitals in Osaka Prefecture, Japan. Patients were divided into two groups based on age at diagnosis (<75 and ≥75 years). The effect of adjuvant chemotherapy was analyzed using Cox proportional hazards regression models for all-cause mortality with inverse probability weighting of propensity scores. Adjusted hazard ratios were estimated for both age groups. Results: A total of 783 patients were analyzed; 476 (60.8%) were aged <75 years and 307 (39.2%) were aged ≥75 years. The proportion of older patients who received adjuvant chemotherapy (36.8%) was substantially lower than that of younger patients (73.3%). In addition, the effect of adjuvant chemotherapy was different between the age groups: the adjusted hazard ratio was 0.56 (95% confidence interval: 0.33-0.94, P=0.027) in younger patients and 1.07 (0.66-1.74, P=0.78) in older patients. Conclusions: The clinical effectiveness of adjuvant chemotherapy in older patients with stage III colon cancer appears limited under current utilization practices.

scholarly journals Effect of adjuvant chemotherapy on survival benefit in stage III colon cancer patients stratified by age: a Japanese real-world cohort study

2019 ◽  
Author(s):  
Hidetaka Kawamura ◽  
Toshitaka Morishima ◽  
Akira Sato ◽  
Michitaka Honda ◽  
Isao Miyashiro
Keyword(s):  
Colon Cancer ◽  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Survival Benefit ◽  
Older Patients ◽  
Age Groups ◽  
Stage Iii ◽  
Younger Patients ◽  
Stage Iii Colon Cancer

Abstract Background: Adjuvant chemotherapy is relatively underused in older patients with colon cancer in Japan, and its age-specific effects on clinical outcomes remain unclear. This study aimed to assess the effect of adjuvant chemotherapy on survival benefit in stage III colon cancer patients stratified by age in a Japanese real-world setting. Methods: In this multi-center retrospective cohort study, we analyzed patient-level information through a record linkage of population-based cancer registry data and administrative claims data. The study population comprised patients aged ≥18 years who received a pathological diagnosis of stage III colon cancer and underwent curative resection between 2010 and 2014 at 36 cancer care hospitals in Osaka Prefecture, Japan. Patients were divided into two groups based on age at diagnosis (<75 and ≥75 years). The effect of adjuvant chemotherapy was analyzed using Cox proportional hazards regression models for all-cause mortality with inverse probability weighting of propensity scores. Adjusted hazard ratios were estimated for both age groups. Results: A total of 783 patients were analyzed; 476 (60.8%) were aged <75 years and 307 (39.2%) were aged ≥75 years. The proportion of older patients who received adjuvant chemotherapy (36.8%) was substantially lower than that of younger patients (73.3%). In addition, the effect of adjuvant chemotherapy was different between the age groups: the adjusted hazard ratio was 0.56 (95% confidence interval: 0.33-0.94, P=0.027) in younger patients and 1.07 (0.66-1.74, P=0.78) in older patients. Conclusions: The clinical effectiveness of adjuvant chemotherapy in older patients with stage III colon cancer appears limited under current utilization practices.

scholarly journals Effect of adjuvant chemotherapy on survival benefit in stage III colon cancer patients stratified by age: a Japanese real-world cohort study

2019 ◽  
Author(s):  
Hidetaka Kawamura ◽  
Toshitaka Morishima ◽  
Akira Sato ◽  
Michitaka Honda ◽  
Isao Miyashiro
Keyword(s):  
Colon Cancer ◽  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Survival Benefit ◽  
Older Patients ◽  
Age Groups ◽  
Stage Iii ◽  
Younger Patients ◽  
Stage Iii Colon Cancer

Abstract Background: Adjuvant chemotherapy is relatively underused in older patients with colon cancer in Japan, and its age-specific effects on clinical outcomes remain unclear. This study aimed to assess the effect of adjuvant chemotherapy on survival benefit in stage III colon cancer patients stratified by age in a Japanese real-world setting. Methods: In this multi-center retrospective cohort study, we analyzed patient-level information through a record linkage of population-based cancer registry data and administrative claims data. The study population comprised patients aged ≥18 years who received a pathological diagnosis of stage III colon cancer and underwent curative resection between 2010 and 2014 at 36 cancer care hospitals in Osaka Prefecture, Japan. Patients were divided into two groups based on age at diagnosis (<75 and ≥75 years). The effect of adjuvant chemotherapy was analyzed using Cox proportional hazards regression models for all-cause mortality with inverse probability weighting of propensity scores. Adjusted hazard ratios were estimated for both age groups. Results: A total of 783 patients were analyzed; 476 (60.8%) were aged <75 years and 307 (39.2%) were aged ≥75 years. The proportion of older patients who received adjuvant chemotherapy (36.8%) was substantially lower than that of younger patients (73.3%). In addition, the effect of adjuvant chemotherapy was different between the age groups: the adjusted hazard ratio was 0.56 (95% confidence interval: 0.33-0.94, P =0.027) in younger patients and 1.07 (0.66-1.74, P =0.78) in older patients. Conclusions: The clinical effectiveness of adjuvant chemotherapy in older patients with stage III colon cancer appears limited under current utilization practices.

scholarly journals Comparison of adverse events during 5-fluorouracil versus 5-fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer

Cancer ◽  
2012 ◽  
Vol 118 (17) ◽  
pp. 4309-4320 ◽  
Author(s):  
Hanna K. Sanoff ◽  
William R. Carpenter ◽  
Janet Freburger ◽  
Ling Li ◽  
Kun Chen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Adverse Events ◽  
Stage Iii ◽  
Stage Iii Colon Cancer

Administration of adjuvant chemotherapy in older patients with Stage III colon cancer: an observational study

2017 ◽  
Vol 19 (10) ◽  
pp. O358-O364 ◽  
Author(s):  
C. B. M. van den Broek ◽  
C. C. E. M. Puylaert ◽  
A. J. Breugom ◽  
E. Bastiaannet ◽  
A. J. M. de Craen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Observational Study ◽  
Older Patients ◽  
Stage Iii ◽  
Stage Iii Colon Cancer
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