scholarly journals Contraindicated Use of Bevacizumab and Toxicity in Elderly Patients With Cancer

2013 ◽  
Vol 31 (28) ◽  
pp. 3592-3599 ◽  
Author(s):  
Dawn L. Hershman ◽  
Jason D. Wright ◽  
Emerson Lim ◽  
Donna L. Buono ◽  
Wei Yann Tsai ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Metastatic Breast ◽  
Tumor Type ◽  
Lower Socioeconomic Status ◽  
Patients With Cancer ◽  
Lower Socioeconomic ◽  
Black Patients ◽  
Medicare Database ◽  
To Receive

Purpose Drugs are approved on the basis of randomized trials conducted in selected populations. However, once approved, these treatments are usually expanded to patients ineligible for the trial. Patients and Methods We used the SEER-Medicare database to identify subjects older than 65 years with metastatic breast, lung, and colon cancer, diagnosed between 2004 and 2007 and undergoing follow-up to 2009, who received bevacizumab. We defined a contraindication as having at least two billing claims before bevacizumab for thrombosis, cardiac disease, stroke, hemorrhage, hemoptysis, or GI perforation. We defined toxicity as first development of one of these conditions after therapy. Results Among 16,085 metastatic patients identified, 3,039 (18.9%) received bevacizumab. Receipt of bevacizumab was associated with white race, later year of diagnosis, tumor type, and decreased comorbid conditions. Of patients who received bevacizumab, 1,082 (35.5%) had a contraindication. In multivariate analysis, receipt of bevacizumab with a contraindication was associated with black race (odds ratio [OR] = 2.6; 95% CI, 1.4 to 4.9), increased age, comorbidity, later year of diagnosis, and lower socioeconomic status. Patients with lung (OR = 1.7; 95% CI, 1.1 to 2.4) and colon cancer (OR = 1.4; 95% CI, 1.1 to 1.9) were more likely to have a contraindication. In the group with no contraindication, 30% had a complication after bevacizumab; black patients were more likely to have a complication than were white patients (OR = 1.9; 95% CI, 1.21 to 2.93). Conclusion Our study demonstrates widespread use of bevacizumab among patients who had contraindications. Black patients were less likely to receive the drug, but those who did were more likely to have a contraindication. Efforts to understand toxicity and efficacy in populations excluded from clinical trials are needed.

scholarly journals Risk of primary gastrointestinal cancers following incident non-metastatic breast cancer: a Danish population-based cohort study

2020 ◽  
Vol 7 (1) ◽  
pp. e000413
Author(s):  
Kasper Adelborg ◽  
Dóra Körmendiné Farkas ◽  
Jens Sundbøll ◽  
Lidia Schapira ◽  
Suzanne Tamang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colon Cancer ◽  
Cohort Study ◽  
Metastatic Breast Cancer ◽  
Stomach Cancer ◽  
Metastatic Breast ◽  
Population Based ◽  
Gastrointestinal Cancers ◽  
Increased Risk

ObjectiveWe examined the risk of primary gastrointestinal cancers in women with breast cancer and compared this risk with that of the general population.DesignUsing population-based Danish registries, we conducted a cohort study of women with incident non-metastatic breast cancer (1990–2017). We computed cumulative cancer incidences and standardised incidence ratios (SIRs).ResultsAmong 84 972 patients with breast cancer, we observed 2340 gastrointestinal cancers. After 20 years of follow-up, the cumulative incidence of gastrointestinal cancers was 4%, driven mainly by colon cancers. Only risk of stomach cancer was continually increased beyond 1 year following breast cancer. The SIR for colon cancer was neutral during 2–5 years of follow-up and approximately 1.2-fold increased thereafter. For cancer of the oesophagus, the SIR was increased only during 6–10 years. There was a weak association with pancreas cancer beyond 10 years. Between 1990–2006 and 2007–2017, the 1–10 years SIR estimate decreased and reached unity for upper gastrointestinal cancers (oesophagus, stomach, and small intestine). For lower gastrointestinal cancers (colon, rectum, and anal canal), the SIR estimate was increased only after 2007. No temporal effects were observed for the remaining gastrointestinal cancers. Treatment effects were negligible.ConclusionBreast cancer survivors were at increased risk of oesophagus and stomach cancer, but only before 2007. The risk of colon cancer was increased, but only after 2007.

Prospectively randomized trial of postoperative adjuvant chemotherapy in patients with high-risk colon cancer.

1998 ◽  
Vol 16 (1) ◽  
pp. 295-300 ◽  
Author(s):  
M J O'Connell ◽  
J A Laurie ◽  
M Kahn ◽  
R J Fitzgibbons ◽  
C Erlichman ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Patient Survival ◽  
Postoperative Adjuvant Chemotherapy ◽  
Standard Regimen ◽  
Treatment Groups ◽  
Intensive Course ◽  
To Receive

PURPOSE This study had two major goals: (1) to assess the effectiveness of a regimen of fluorouracil (5-FU) plus levamisole plus leucovorin as postoperative surgical adjuvant therapy for patients with high-risk colon cancer, and (2) to evaluate 6 months versus 12 months of chemotherapy. PATIENTS AND METHODS Patients with poor-prognosis stage II or III colon cancer were randomly assigned to receive adjuvant chemotherapy with either intensive-course 5-FU and leucovorin combined with levamisole, or a standard regimen of 5-FU plus levamisole. Patients were also randomly assigned to receive either 12 months or 6 months of chemotherapy, which resulted in four treatment groups. RESULTS Eight hundred ninety-one of 915 patients entered (97.4%) were eligible. The median follow-up duration is 5.1 years for patients still alive. There was a difference among the four treatment groups with respect to patient survival, and a significant duration-by-regimen interaction was observed. Specifically, standard 5-FU plus levamisole was inferior to 5-FU plus leucovorin plus levamisole when treatment was given for 6 months (5-year survival rate, 60% v 70%; P < .01). CONCLUSION There was no significant improvement in patient survival when chemotherapy was given for 12 months compared with 6 months. When chemotherapy was given for 6 months, standard 5-FU plus levamisole was associated with inferior patient survival compared with intensive-course 5-FU plus leucovorin plus levamisole. These data suggest that 5-FU plus levamisole for 6 months should not be used in clinical practice, whereas 6 months of treatment with 5-FU plus leucovorin plus levamisole is effective.

Risk factors for incidence of trachomatous scarring in a cohort of women in low endemic district

2018 ◽  
Vol 102 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Rabia Karani ◽  
Meraf Wolle ◽  
Harran Mkocha ◽  
Beatriz Muñoz ◽  
Sheila K West
Keyword(s):  
Socioeconomic Status ◽  
Logistic Regression ◽  
Demographic Factors ◽  
Bivariate Analysis ◽  
Fire Exposure ◽  
Lower Socioeconomic Status ◽  
Multivariable Logistic Regression Model ◽  
Lower Socioeconomic ◽  
Endemic District

Background/aimsTo determine the incidence of scarring in women in a trachoma low endemic district of rural Tanzania and to determine the effects of lifetime cooking fire exposure and markers of lower socioeconomic status on incidence of scarring in these women.MethodsA prospective cohort study was conducted over a 3.5-year period from 2013 to 2016 in 48 villages in Kongwa, Tanzania where trachoma at baseline was 5.2% in children. A random sample of 2966 women aged 15 and older who were at risk for incident scarring were eligible for follow-up. Data on demographic factors, cooking fire exposure and trachomatous scarring were gathered at baseline and follow-up. An index of lifetime exposure to cooking fire exposure was created and bivariate analysis, age-adjusted logistic regression and multivariable logistic models were used to look for associations of demographic factors and cooking fire exposure with incident trachomatous scarring.ResultsThe cumulative incidence of scarring was 7.1% or 2.0% per year. Incidence of scarring increased with age and exposure to markers of lower socioeconomic status. A multivariable logistic regression model adjusting for confounding factors did not find an association between lifetime cooking fire exposure and incidence of scarring (OR=0.92; 95% CI 0.68 to 1.24, P=0.58).ConclusionsThere was still incident scarring in women in Tanzania despite low rates of active trachoma. There was no association between exposure to cooking fires and incident scarring. More research is needed to understand the factors that contribute to new scarring in these women.

Oxaliplatin/5FU/LV in adjuvant colon cancer: Updated efficacy results of the MOSAIC trial, including survival, with a median follow-up of six years

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4007-4007 ◽  
Author(s):  
A. de Gramont ◽  
C. Boni ◽  
M. Navarro ◽  
J. Tabernero ◽  
T. Hickish ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Disease Free Survival ◽  
Significant Benefit ◽  
Stage Ii ◽  
Free Survival ◽  
Resected Stage ◽  
To Receive ◽  
Disease Free

4007 Background: The MOSAIC study was designed to evaluate the effects of the FOLFOX4 regimen (5-FU/LV + oxaliplatin) on 3- year disease free survival (DFS) probability in patients with stage II and III colon cancer. Methods: Patients (n=2246) with completely resected stage II (40%) or III (60%) colon cancer were randomly assigned to receive 5-FU/LV (LV5FU2) or FOLFOX4 every 2 weeks for 12 cycles. Results: Results for the primary endpoint of the study (for the overall population, with a median follow-up [FU] of 3 years), showed a significant benefit in DFS for the FOLFOX4-treated patients (78.2% vs 72.9%; HR: 0.77, p=0.002) (André et al, NEJM, 2004). Patients were followed beyond the 3-year cut-off for DFS and overall survival (OS) updates. Final DFS, at 5 years FU, are consistent with earlier results (HR: 0.80, p = 0.003). In addition, at a median FU of 6 years, the study demonstrates a significant benefit in OS for the stage III patients. Summary of OS results (median FU 6 years) Long-term safety update shows no increase in the rate of secondary cancer (5.0% in both treatment arms). Conclusions: These results confirm the benefit of the FOLFOX4 regimen in adjuvant colon cancer patients. [Table: see text] No significant financial relationships to disclose.

Activity and duration of chemotherapy (CT) in different biologic subtype (BS) in metastatic breast cancer (MBC) patients (P).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1036-1036
Author(s):  
Claudia Bighin ◽  
Lucia Del Mastro ◽  
Beatrice Dozin ◽  
Sara Giraudi ◽  
Alessia Levaggi ◽  
...  
Keyword(s):  
Metastatic Breast ◽  
Median Number ◽  
The Other ◽  
Luminal A ◽  
Chi Square ◽  
Luminal B ◽  
Kaplan Meier ◽  
Biologic Subtype ◽  
To Receive

1036 Background: In MBC P the benefit of CT after the 1st line (L) is poorly defined. We evaluated activity of subsequent L of CT in different BS of MBC. Methods: MBC P treated in our center from 2007 to 2012 with ER, PgR and HER2 on primary tumor and at least 1 L of CT for MBC were evaluated. P were classified as Luminal A (ER and/or PgR +, HER2 -, Ki67≤14%), Luminal B (ER and/or PgR +, HER2 -, Ki67>14%), HER2+ (HER2+, any ER/PgR) and Triple-Negative ( ER-, PgR- and HER2-). Time on CT was calculated from the start of the 1st L to the end of the last L. Statistical analyses included Chi-square and Kruskal-Wallis tests, Kaplan-Meier curves and log-rank tests, and multivariate logistic regressions. Results: 207 P were identified, 52 were excluded because HER2 was unknown (19) or they did not receive any CT (33). Median follow-up was 31.4 months (m). The median number (N) of CT L was 2 (range 1-10). N of CT L and clinical benefit (CB) for every BS were reported in table. CB was inferior in TN P as compared with the other ones in 1st and in 2nd L ( p=.068 and p=.084 respectively in 1st and 2nd L). From 3rd L onward all P showed the same CB independently from BS. Time on CT related to median survival (S) for every BS was the same. At multivariate analysis the characteristics independently associated with a greater probability of receiving more than 4 CT L were age < 50 years (p=.021), HER2+ or TN disease (p=.027) and site of metastasis other than lung (p=.047). Conclusions: Our analysis showed that, despite the same time spent on CT, TN P received less benefit from 1st and 2nd L CT than other BS. On the other hand, young HER2+ P were more likely to receive multiple L of CT with a significant impact on median S (p=.044). [Table: see text]

Achieving Health Equity in Colorectal Cancer: A Call to Action

2013 ◽  
pp. 169-173
Author(s):  
Toni M. Cipriano ◽  
Blase N. Polite
Keyword(s):  
Colon Cancer ◽  
Health Disparities ◽  
Lifestyle Changes ◽  
Call To Action ◽  
Appropriate Treatment ◽  
Timely Fashion ◽  
Cancer Specific Mortality ◽  
Race Ethnicity ◽  
To Receive

Whether defined by race, ethnicity, or socioeconomic status, there are clear health disparities in colon cancer—disparities that exist whether you measure screening, incidence, or mortality. Rather than rehash disparity statistics, the purpose of this educational article is to highlight important resources and how they can be used to help narrow these disparities. Although the logistics can be complex, the general solutions to eliminating colon cancer health disparities are not complex. They are as follows: Asymptomatic persons need to be screened. After being screened, they need to be diagnosed. After being diagnosed, they need to receive appropriate treatment in a timely fashion. After receiving treatment, they have to receive appropriate follow-up and information and advice on lifestyle changes. If we can implement these measures, then cancer-specific mortality disparities will be dramatically reduced, if not eliminated.

scholarly journals Evaluating the Need for Anticoagulation Beyond 6 Months for Patients with Cancer-Associated Venous Thromboembolism: A Retrospect of Real Life (EXTEND Study)

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4245-4245
Author(s):  
Martha L Louzada ◽  
Michael J. Kovacs ◽  
Fatimah Al-ani ◽  
Lenicio Siqueira ◽  
Alejandro Lazo-Langner
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Complete Remission ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Recurrence Risk ◽  
Patients With Cancer ◽  
Cancer Associated Thrombosis

Abstract Background: The association between cancer and venous thromboembolism (VTE) has been well documented. In patients with cancer, the risk for a first cancer- associated thrombosis is 5 to 28-fold higher than in non-cancer patients. Current oncology clinical practice guidelines recommend that patients with cancer- associated thrombosis be treated for a minimum of 6 months with low molecular weight heparin (LMWH) provided they do not have any contraindications to anticoagulant therapy. The length of anticoagulation beyond the initial 6 months is controversial due to the absence of clinical trials data. Panel consensus from the ASCO 2013 clinical practice guidelines recommends continuing anticoagulation if malignancy remains active or patient is still on active anticancer treatment. There is clear equipoise in which type of anticoagulation approach, if any, is the best beyond 6 months of anticoagulation for these patients. In this retrospective analysis we sought to evaluate what has been the extended anticoagulation therapy of choice in our thrombosis clinic over the past 5 years and its efficacy in preventing late recurrent venous thromboembolism. Methods: We conducted a single- centre retrospective cohort study (London, Canada) to collect data from adult patients with cancer -associated VTE who received anticoagulation with therapeutic LMWH for at least 6 months. We collected data from January 2008 to December 2013. We included patients 18 years old or older; with any type of active cancer (except basal cell and squamous cell carcinoma of the skin) or stage. Follow up period started at 6 months of anticoagulation and finished at 12 months (total of 6 months of study follow-up), or at time of a recurrent VTE, or death or last follow up in clinic, whichever came first. We used SAS 9.2 to perform the data analysis. Results: In total 417 patients were potentially eligible but 149 fulfilled our inclusion criteria. 78 (52%) were males, median age was 65 (range 25-86). 123 (82.4%) patients had solid tumors and 26 (17.6%) hematological malignancy. Of the patients with solid tumors, 98 (80.3%) had stage III or IV disease. The most frequent primary tumor sites were colorectal (n= 36; 34%), lung (n=29;20%) and pancreas (n= 17; 11%) among others (n= 41). After the first 6 months of anticoagulation, 20 (13%) patients were considered to be in complete remission of their cancer. In total, 45 of 149 (31%) patients discontinued anticoagulant therapy. 64 (43%) remained on full weight-adjusted dose LMWH, 10 (6%) on prophylactic dose, 29 (19%) were switched to warfarin and 1 (1%) to rivaroxaban. Of the 45 patients that discontinued anticoagulation, 7 were considered to be in complete remission. Overall, there were 21 (14%) VTE recurrences after the first 6 months of anticoagulation. 12 (57%) occurred in patients using full dose LMWH. Patients in complete remission had a lower risk for VTE recurrence (OR= 0.31; 95%CI: 0.102 - 0.920; p= 0.0349). Although not statistically significant, there is a trend of high VTE recurrence risk in patients with lung or colon cancer, or stage III/IV and for patients on full doseLMWH (Table). A post-hoc power calculation of our study demonstrated 84% power with a 2-sided alpha of 0.05. Conclusion: Our study demonstrated a significant increased risk for recurrent VTE (14%) in after the firs 6 months of anticoagulation in patients with cancer-associated VTE irrespective of anticoagulation approach. Being in complete remission is significantly associated with a low risk for recurrence. Having lung or colon cancer or advanced stage may increase recurrence risk. Interestingly, patients on full LMWH also showed trend to high VTE recurrence risk. This may reflect a sicker subset of patients with an inherent higher VTE risk. Further prospective trials are warranted to better study the best anticoagulation approach for patients with cancer-associated VTE beyond the first 6 months of anticoagulation. Table. Univariate analysis for the association of VTE recurrence and tunor and patients characteristics Variables OR (95%CI)# P -value Female 0.58 (0.2 - 1.7) 0.321 Warfarin 0.97 (0.3 - 3.1) 0.958 Prophylactic LMWH^ 0.75 (0.09 - 6.3) 0.791 Full LMWH^ 1.56 (0.62 - 3.9) 0.348 Colorectal* 1.69 (0.4 - 6.4) 0.443 Lung* 1.76 (0.4 - 7.0) 0.422 Pancreas* 0.90 (0.15 - 5.5) 0.909 stageIII or IV 1.93 (0.67 - 5.5) 0.223 #odds ratio ( 95% confidence interval) ^ reference: no anticoagulation * reference: hematological cancer Disclosures No relevant conflicts of interest to declare.

Circulating tumor DNA-based decision for adjuvant treatment in colon cancer stage II evaluation: (CIRCULATE-trial) AIO-KRK-0217.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. TPS273-TPS273
Author(s):  
Gunnar Folprecht ◽  
Anke Reinacher-Schick ◽  
Andrea Tannapfel ◽  
Juergen Weitz ◽  
Thibaud Kossler ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Circulating Tumor Dna ◽  
Stage Ii ◽  
Patient Specific ◽  
Cancer Stage ◽  
To Receive ◽  
Colon Cancer Stage Ii

TPS273 Background: The benefit of adjuvant chemotherapy in stage II colon cancer is unclear, and clear clinical or molecular marker are not available for decision making. Recently, postoperative circulating tumour (ct)DNA has been demonstrated to be prognostic in colorectal cancer and other tumours. Methods: For the CIRCULATE trial we enrol patients (pts) with colon cancer stage II in Germany (AIO), Austria (ABCSG) and Switzerland (SAKK). Microsatellite stable pts are screened after resection of the primary by analysing the tumour block with panel sequencing and measuring patient specific mutations in the postoperative plasma sample. MSI-H pts are excluded from the trial. ctDNA positive (ctDNApos) pts are randomised (2:1) to receive adjuvant capecitabine based chemotherapy or no chemotherapy. Oxaliplatin can be added according to investigator’s choice. ctDNA negative (ctDNAneg) pts are randomised (1:4) to be followed-up within the study or to receive standard follow-up outside the trial. Pts in the follow-up group and their investigators are blinded for the ctDNA result. The primary aim is to compare the disease free survival (DFS) in ctDNApos pts randomised to chemotherapy or to follow-up. Secondary aims are to compare the overall survival (OS) in ctDNApos pts with or without chemo, to compare the DFS and OS in ctDNApos vs. ctDNAneg follow-up pts, to describe the DFS and OS in ctDNAneg pts, to describe the location of recurrences/metastases according ctDNA status, the ctDNA clearance rate and time to ctDNA negativity during adjuvant chemotherapy, further translational endpoints, and safety. To demonstrate a treatment effect in the ctDNA group with a hazard ratio of 0.617 (3 year DFS rate of 42.5 % vs. 25 %), 231 ctDNApos will be randomised (approx. 2310 pts in total) from 2019 – 2022. Clinical trial information: NCT04089631.

Effects of Parenteral Hydration in Terminally Ill Cancer Patients: A Preliminary Study

2005 ◽  
Vol 23 (10) ◽  
pp. 2366-2371 ◽  
Author(s):  
Eduardo Bruera ◽  
Raul Sala ◽  
Maria Antonieta Rico ◽  
Jairo Moyano ◽  
Carlos Centeno ◽  
...  
Keyword(s):  
Treatment Group ◽  
Cancer Patients ◽  
Symptom Control ◽  
Terminally Ill ◽  
Oral Intake ◽  
Well Being ◽  
Terminally Ill Cancer Patients ◽  
Patients With Cancer ◽  
To Receive

Purpose Most patients with cancer develop decreased oral intake and dehydration before death. This study aimed to determine the effect of parenteral hydration on overall symptom control in terminally ill cancer patients with dehydration. Patients and Methods Patients with clinical evidence of mild to moderate dehydration and a liquid oral intake less than 1,000 mL/day were randomly assigned to receive either parenteral hydration with 1,000 mL (treatment group) or placebo with 100 mL normal saline administered over 4 hours for 2 days. Patients were evaluated for target symptoms (hallucinations, myoclonus, fatigue, and sedation), global well-being, and overall benefit. Results Twenty-seven patients randomly assigned to the treatment group had improvement in 53 (73%) of their 73 target symptoms versus 33 (49%) of 67 target symptoms in the placebo group (n=22; P = .005). Fifteen (83%) of 18 and 15 (83%) of 18 patients had improved myoclonus and sedation after hydration versus eight (47%) of 17 and five (33%) of 15 patients after placebo (P = .035 and P = .005, respectively). There were no significant differences of improvement in hallucinations or fatigue between groups. When blinded to treatment, patients (17 [63%] of 77) and investigators (20 [74%] of 27) perceived hydration as effective compared with placebo in nine (41%) of 22 patients (P = .78) and 12 (54%) of 22 investigators (P = .15), respectively. The intensity of pain and swelling at the injection site were not significantly different between groups. Conclusion Parenteral hydration decreased symptoms of dehydration in terminally ill cancer patients who had decreased fluid intake. Hydration was well tolerated, and a placebo effect was observed. Studies with larger samples and a longer follow-up period are justified.

Adjuvant active specific immunotherapy for human colorectal cancer: 6.5-year median follow-up of a phase III prospectively randomized trial.

1993 ◽  
Vol 11 (3) ◽  
pp. 390-399 ◽  
Author(s):  
H C Hoover ◽  
J S Brandhorst ◽  
L C Peters ◽  
M G Surdyke ◽  
Y Takeshita ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Patients ◽  
Specific Immunotherapy ◽  
Disease Free Survival ◽  
Free Survival ◽  
Active Specific Immunotherapy ◽  
To Receive ◽  
Disease Free

PURPOSE Patients with colon or rectal cancer were entered onto a prospectively randomized, controlled clinical trial of active specific immunotherapy (ASI) with an autologous tumor cell-bacillus Calmette-Guérin (BCG) vaccine. We investigated whether ASI could improve disease-free status and survival. PATIENTS AND METHODS Ninety-eight patients with Dukes' stage B2-C3 colon or rectal cancer were randomized into groups treated by resection alone or resection plus ASI. Eighty patients met all eligibility criteria. All patients with rectal cancer were to receive 50 Gy of pelvic irradiation. Analysis of distribution of survival and disease-free survival was made on all eligible patients until December 31, 1990. RESULTS As a single study, no statistically significant differences were detected in survival or disease-free survival for all 80 eligible patients. However, since it was recognized at the outset that there were treatment differences, in that rectal cancer patients were to receive postimmunotherapy radiation, it was considered that a cohort analysis of the colon and rectal cancer patients might be informative. With a median follow-up of 93 months, there is a significant improvement in survival (two-sided P = .02; hazards ratio, 3.97) and disease-free survival (two-sided P = .039; hazards ratio, 2.67) in all eligible colon cancer patients who received ASI. With a median follow-up of 58 months, no benefits were seen in patients with rectal cancer who received ASI. CONCLUSION This study suggests that ASI may be beneficial to patients with colon cancer.

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