scholarly journals Noninferiority of three monthsversussix months of oxaliplatin‐based adjuvant chemotherapy for resected colon cancer. How shouldIDEAfindings affect clinical practice?

2018 ◽  
Vol 143 (10) ◽  
pp. 2342-2350 ◽  
Author(s):  
Vincenzo Formica ◽  
Alberto Zaniboni ◽  
Fotios Loupakis ◽  
Mario Roselli
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy

scholarly journals Reasons for delay in timely administration of adjuvant chemotherapy for patients with stage III colon cancer: a multicentre cohort study from the McGill University Department of Oncology

2021 ◽  
Vol 10 (1) ◽  
pp. e000934
Author(s):  
Arielle Elkrief ◽  
Genevieve Redstone ◽  
Luca Petruccelli ◽  
Alla'a Ali ◽  
Doneal Thomas ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cox Regression ◽  
Health Centre ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Mcgill University

PurposeAdjuvant chemotherapy within 56 or 84 days following curative resection is globally accepted as the standard of care for stage III colon cancer as it has been associated with improved overall survival. Initiation of adjuvant chemotherapy within this time frame is therefore recommended by clinical practice guidelines, including the European Society for Medical Oncology. The objective of this study was to evaluate adherence to these clinical practice guidelines for patients with stage III colon cancer across the Rossy Cancer Network (RCN); a partnership of McGill University’s Faculty of Medicine, McGill University Health Centre, Jewish General Hospital and St Mary’s Hospital Center.Patients and methods187 patients who had been diagnosed with stage III colon cancer and received adjuvant chemotherapy within the RCN partner hospitals from 2012 to 2015 were included. Patient and treatment information was retrospectively determined by chart review. Χ2 and Wilcoxon rank-sum tests were used to measure associations and a multivariate Cox regression model was used to determine risk factors contributing to delays in administration of adjuvant chemotherapy.ResultsThe median turnaround time between surgery and adjuvant chemotherapy was 69 days. Importantly, only 27% of patients met the 56-day target, and 71% met the 84-day target. Increasing age, having more than one surgical complication and being diagnosed between 2013–2014 and 2014–2015 reduced the likelihood that patients met these targets. Furthermore, delays were observed at most intervals from surgery to first adjuvant chemotherapy treatment.ConclusionOur study found that within these academic hospital settings, 27% of patients met the 56-day target, and 71% met the 84-day target. Delays were associated with hospital, surgeon and patient-related factors. Initiatives in quality improvement are needed in order to improve adherence to recommended treatment guidelines for prompt administration of adjuvant chemotherapy for stage III colon cancer.

Uptake of adjuvant chemotherapy for colon cancer in older and younger patients in the Irish population.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 478-478
Author(s):  
Seamus Coyle ◽  
Zia Rehman ◽  
Chalen Lee ◽  
Sandra Deady ◽  
Harry Comber ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Older Patients ◽  
The Elderly ◽  
Stage Ii ◽  
Stage Iii ◽  
Younger Patients ◽  
The Impact

478 Background: Colon cancer is predominantly a disease of the elderly, with recent evidence supporting the use of adjuvant chemotherapy in the older population. However, it remains unclear to what degree such patients are receiving adjuvant therapy in clinical practice. We examined uptake of adjuvantchemotherapy and it’s impact on survival in older patients with stage II and stage III colon cancer in a national cohort. Methods: Using the National cancer Registry of Ireland, we identified 3,486 patients with stage II and III colon cancer who were treated with curative resection from 2004-2009. Clinopathological features and chemotherapy use were compared between those ≥70 years and those < 70 years. Results: A total of 2,026 patients with stage II disease were identified, 56% male and 60% ≥ 70 years. T3 tumors accounted for 81%, T4 19% and 89% were grade 2/3. Adjuvant chemotherapy was utilized in 10% and 40% of ≥ 70 and <70 years, respectively (p<0.0001). A benefit for chemotherapy over observation alone was seen in both the older [HR 0.36; 95% CI 0.36 – 0.68; p <0.0001] and younger patient groups [HR 0.43; 95% CI 0.2701 - 0.6881; p<0.0004]. Of 1,460 patients with stage III disease, 51% were ≥ 70 years, 54% male. 34% of older and 83% of younger patients received adjuvant therapy (p<0.0001). A similar magnitude of benefit from chemotherapy compared to observation was seen in patients ≥ 70 years [HR 0.30; 95% CI 0.29 - 0.45 ; p <0.0001] and <70 years [HR 0.22 95%CI 0.1 – 0.2; p<0.0001] with stage III disease. Conclusions: Adoption of adjuvant chemotherapy appears to be associated with significant survival benefit in older patients (age ≥ 70 years), however, is still underutilized in clinical practice. The impact of sociodemographic and clinicopathological features as potential drivers of treatment decisions in a cohort of this population will be reported.

Oxaliplatin/5-fluorouracil-based adjuvant chemotherapy as a standard of care for colon cancer in clinical practice: Outcomes of the ACCElox registry

2015 ◽  
Vol 11 (4) ◽  
pp. 334-342 ◽  
Author(s):  
Young Suk Park ◽  
Jiafu Ji ◽  
John Raymond Zalcberg ◽  
Mostafa El-Serafi ◽  
Antonio Buzaid ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Standard Of Care

scholarly journals Clinical Practice in the Use of Adjuvant Chemotherapy for Patients with Colon Cancer in South Korea: a Multi-Center, Prospective, Observational Study

2016 ◽  
Vol 7 (2) ◽  
pp. 136-143
Author(s):  
Jung Han Kim ◽  
Moo Jun Baek ◽  
Byung-Kwon Ahn ◽  
Dae Dong Kim ◽  
Ik Yong Kim ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Observational Study ◽  
South Korea ◽  
Prospective Observational Study

scholarly journals Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain

2020 ◽  
Vol 17 (18) ◽  
pp. 6697
Author(s):  
Francisco Carrasco-Peña ◽  
Eloisa Bayo-Lozano ◽  
Miguel Rodríguez-Barranco ◽  
Dafina Petrova ◽  
Rafael Marcos-Gragera ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
High Resolution ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Population Based ◽  
Population Based Study ◽  
Stage Iii Colon Cancer

Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relationship with survival. We conducted a retrospective high-resolution population-based study of 1050 incident CRC cases from the cancer registries of Granada and Girona, with a 5-year follow-up. We recorded clinical, diagnostic, and treatment-related information and assessed adherence to nine quality indicators of the relevant CRC guidelines. Overall adherence (on at least 75% of the indicators) significantly reduced the excess risk of death (RER) = 0.35 [95% confidence interval (CI) 0.28–0.45]. Analysis of the separate indicators showed that patients for whom complementary imaging tests were requested had better survival, RER = 0.58 [95% CI 0.46–0.73], as did patients with stage III colon cancer who underwent adjuvant chemotherapy, RER = 0.33, [95% CI 0.16–0.70]. Adherence to clinical practice guidelines can reduce the excess risk of dying from CRC by 65% [95% CI 55–72%]. Ordering complementary imagining tests that improve staging and treatment choice for all CRC patients and adjuvant chemotherapy for stage III colon cancer patients could be especially important. In contrast, controlled delays in starting some treatments appear not to decrease survival.

Adjuvant Systemic Therapies in Patients with Colorectal Cancer: An Audit on Clinical Practice in Italy

2005 ◽  
Vol 91 (6) ◽  
pp. 472-476 ◽  
Author(s):  
◽  
Fausto Roila ◽  
Benedetta Ruggeri ◽  
Enzo Ballatori ◽  
Lucio Patoia ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Daily Clinical Practice ◽  
Stage Ii ◽  
International Consensus ◽  
Systemic Therapies

Aims and Background Rarely are conclusions from clinical trials summarized in international consensus conferences and promptly transferred to patient care. The adjuvant therapy for colorectal cancer used in daily clinical practice in Italy is described and compared with the recommendations of the 1990 NIH Consensus Conference. Patients and Methods We audited prescriptions of adjuvant systemic therapies for Italian colorectal cancer patients in 82 centers during a fixed one-week period. Results Among 434 patients receiving adjuvant chemotherapy there were 139 (42.5%) colon cancer patients with N- and 169 (51.7%) with N+ regional nodal involvement. Treatment at academic centers, a young age, T4 and a low total number of lymph nodes removed at surgery were the factors potentially justifying the decision for adjuvant chemotherapy in stage II colon cancer patients. The most common chemotherapy used was a bolus of 5-fluorouracil/folinic acid for 6 months (75.8%). Adjuvant radiotherapy was not administered to 37 (38.5%) of 96 patients with stage II and III rectal cancer. Conclusions The study shows that a substantial proportion of patients on adjuvant treatment at a certain time point in a large enough sample of Italian centers are stage II (potential over-treatment) and that an under-treatment of stage II and III rectal cancer patients (lack of radiotherapy) occurs too often in daily clinical practice in this country.

Adjuvant chemotherapy for stage II colon cancer: influence of care structuresʼ characteristics on a controversial clinical practice

2007 ◽  
Vol 19 (11) ◽  
pp. 995-1001 ◽  
Author(s):  
Eléonore Alter ◽  
Jean-Marc Phelip ◽  
Jean-Noel Guilhot ◽  
Michel Matysiak ◽  
Michel Vermorel ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Stage Ii Colon Cancer

Understanding why some people with stage III colon cancer do not receive adjuvant chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14608-e14608
Author(s):  
Valerie Heong ◽  
Hui-Li Wong ◽  
Jeanne Tie ◽  
Michael Jefford ◽  
Kathryn Maree Field ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Age Groups ◽  
Routine Clinical Practice ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
N2 Disease ◽  
Co Morbidity

e14608 Background: Adjuvant chemotherapy is a standard of care for patients (pts) with stage III colon cancer. While many retrospective series have concluded that treatment is underutilised in routine clinical practice, particularly in older pts, reasons for this remain unexplored. Methods: Data was collected on all pts with stage III colon cancer attending four community hospitals in Australia between January 2003 and July 2012. Every patient was referred to a medical oncologist. For each case where adjuvant therapy was not delivered, reason(s) were prospectively documented by clinicians in a consensus database. Results: Data was collected on 875 pts. Median age 67 years (range 15 - 92). Overall, 147 (25.9%) did not receive adjuvant therapy. Comorbidity was the main reason for non-treatment in all age groups. Age alone was the reason for not recommending treatment in a small number of elderly pts (n=20, 20.4%). Risk of recurrence (N1 vs N2 disease) did not impact recommendations of clinicians (75% vs 76%) or pt acceptance (92% vs 93%). Pts with a lower socioeconomic status were less likely to be offered treatment; however this reflected greater comorbidity in these pts. Treatment acceptance was similar across all socioeconomic groups (data not shown). Conclusions: In routine clinical practice adjuvant chemotherapy should be recommended to, and can be safely delivered to a very high proportion of younger patients. Clinicians are comfortable recommending adjuvant chemotherapy to older pts, with co-morbidity the dominant reason that treatment was not recommended for pts >65 years. The rate of pts declining treatment increased with age, and further study of the factors involved in treatment refusal should be pursued [Table: see text]

Patient Age and Comorbidity Are Major Determinants of Adjuvant Chemotherapy Use for Stage III Colon Cancer in Routine Clinical Practice

2008 ◽  
Vol 26 (27) ◽  
pp. 4516-4517 ◽  
Author(s):  
Sumitra Ananda ◽  
Kathryn M. Field ◽  
Suzanne Kosmider ◽  
Daniel Compston ◽  
Jayesh Desai ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Routine Clinical Practice ◽  
Stage Iii ◽  
Patient Age ◽  
Stage Iii Colon Cancer ◽  
Patient Âgé
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