Failure to complete adjuvant chemotherapy is associated with adverse survival in stage III colon cancer patients

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Abstract

Two recent North American studies have shown that completion of 5-fluorouracil (5FU)-based adjuvant chemotherapy is a major prognostic factor for the survival of elderly stage III colon cancer patients. The aim of the present study was to confirm this finding in a population-based series from Australia. The study cohort comprised 851 stage III colon cancer patients treated by surgery alone and 461 who initiated the Mayo chemotherapy regime. One-third of patients who initiated chemotherapy failed to complete more than three cycles of treatment. Independent predictors for failure to complete were treatment in district or rural hospitals, low socioeconomic index and treatment by a low-volume surgeon. Patients who failed to complete chemotherapy showed worse cancer-specific survival compared not only to those who completed treatment (HR = 2.24; 95% confidence interval (CI) (1.66 - 3.03), P < 0.001) but also to those treated by surgery alone ( HR = 1.37; 95% CI ( 1.09 - 1.72), P = 0.008). The current and previous studies demonstrate the importance of completing adjuvant 5-FU-based chemotherapy for colon cancer. Further prospective studies are required to identify better the physiological and socioeconomic factors responsible for failure to complete chemotherapy so that appropriate improvements in health service delivery can be made.
Original languageEnglish
Pages (from-to)701-707
JournalBritish Journal of Cancer
Volume96
Issue number5
DOIs
Publication statusPublished - 2007

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Adjuvant Chemotherapy
Colonic Neoplasms
Drug Therapy
Survival
Fluorouracil
Confidence Intervals
Rural Hospitals
District Hospitals
Therapeutics
Health Services
Cohort Studies
Prospective Studies
Population
Neoplasms

Cite this

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title = "Failure to complete adjuvant chemotherapy is associated with adverse survival in stage III colon cancer patients",
abstract = "Two recent North American studies have shown that completion of 5-fluorouracil (5FU)-based adjuvant chemotherapy is a major prognostic factor for the survival of elderly stage III colon cancer patients. The aim of the present study was to confirm this finding in a population-based series from Australia. The study cohort comprised 851 stage III colon cancer patients treated by surgery alone and 461 who initiated the Mayo chemotherapy regime. One-third of patients who initiated chemotherapy failed to complete more than three cycles of treatment. Independent predictors for failure to complete were treatment in district or rural hospitals, low socioeconomic index and treatment by a low-volume surgeon. Patients who failed to complete chemotherapy showed worse cancer-specific survival compared not only to those who completed treatment (HR = 2.24; 95{\%} confidence interval (CI) (1.66 - 3.03), P < 0.001) but also to those treated by surgery alone ( HR = 1.37; 95{\%} CI ( 1.09 - 1.72), P = 0.008). The current and previous studies demonstrate the importance of completing adjuvant 5-FU-based chemotherapy for colon cancer. Further prospective studies are required to identify better the physiological and socioeconomic factors responsible for failure to complete chemotherapy so that appropriate improvements in health service delivery can be made.",
author = "M. Morris and Cameron Platell and Lin Fritschi and Barry Iacopetta",
year = "2007",
doi = "10.1038/sj.bjc.6603627",
language = "English",
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pages = "701--707",
journal = "British Journal of Cancer",
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TY - JOUR

T1 - Failure to complete adjuvant chemotherapy is associated with adverse survival in stage III colon cancer patients

AU - Morris, M.

AU - Platell, Cameron

AU - Fritschi, Lin

AU - Iacopetta, Barry

PY - 2007

Y1 - 2007

N2 - Two recent North American studies have shown that completion of 5-fluorouracil (5FU)-based adjuvant chemotherapy is a major prognostic factor for the survival of elderly stage III colon cancer patients. The aim of the present study was to confirm this finding in a population-based series from Australia. The study cohort comprised 851 stage III colon cancer patients treated by surgery alone and 461 who initiated the Mayo chemotherapy regime. One-third of patients who initiated chemotherapy failed to complete more than three cycles of treatment. Independent predictors for failure to complete were treatment in district or rural hospitals, low socioeconomic index and treatment by a low-volume surgeon. Patients who failed to complete chemotherapy showed worse cancer-specific survival compared not only to those who completed treatment (HR = 2.24; 95% confidence interval (CI) (1.66 - 3.03), P < 0.001) but also to those treated by surgery alone ( HR = 1.37; 95% CI ( 1.09 - 1.72), P = 0.008). The current and previous studies demonstrate the importance of completing adjuvant 5-FU-based chemotherapy for colon cancer. Further prospective studies are required to identify better the physiological and socioeconomic factors responsible for failure to complete chemotherapy so that appropriate improvements in health service delivery can be made.

AB - Two recent North American studies have shown that completion of 5-fluorouracil (5FU)-based adjuvant chemotherapy is a major prognostic factor for the survival of elderly stage III colon cancer patients. The aim of the present study was to confirm this finding in a population-based series from Australia. The study cohort comprised 851 stage III colon cancer patients treated by surgery alone and 461 who initiated the Mayo chemotherapy regime. One-third of patients who initiated chemotherapy failed to complete more than three cycles of treatment. Independent predictors for failure to complete were treatment in district or rural hospitals, low socioeconomic index and treatment by a low-volume surgeon. Patients who failed to complete chemotherapy showed worse cancer-specific survival compared not only to those who completed treatment (HR = 2.24; 95% confidence interval (CI) (1.66 - 3.03), P < 0.001) but also to those treated by surgery alone ( HR = 1.37; 95% CI ( 1.09 - 1.72), P = 0.008). The current and previous studies demonstrate the importance of completing adjuvant 5-FU-based chemotherapy for colon cancer. Further prospective studies are required to identify better the physiological and socioeconomic factors responsible for failure to complete chemotherapy so that appropriate improvements in health service delivery can be made.

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DO - 10.1038/sj.bjc.6603627

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SP - 701

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JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 5

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