TY - JOUR
T1 - Real-world adjuvant chemotherapy treatment patterns and outcomes over time for resected stage II and III colorectal cancer
AU - To, Yat Hang
AU - Degeling, Koen
AU - McCoy, Melanie
AU - Wong, Rachel
AU - Jones, Ian
AU - Dunn, Catherine
AU - Hong, Wei
AU - Loft, Matthew
AU - Gibbs, Peter
AU - Tie, Jeanne
PY - 2023/6
Y1 - 2023/6
N2 - Background: The administration of adjuvant chemotherapy (AC) to colorectal cancer (CRC) patients in Australia and impact of recent trial data has not been well reported. We aim to evaluate temporal trends in AC treatment and outcomes in real-world Australian patients. Methods: CRC patients were analyzed from 13 hospitals, stratified by stage (II or III) and three 5-year time periods (A: 2005–2009, B: 2010–2014, C: 2015–2019). Stage III was further stratified as pre- and post publication of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration (March 2018). AC prescription, time-to-recurrence (TTR), and overall survival (OS) was compared across the time periods. Results: Of 3977 identified patients, 1148 (stage II: 640, stage III: 508), 1525 (856 vs. 669), and 1304 (669 vs. 635) were diagnosed in Period A, B, and C, respectively. Fewer patients in Period C received AC compared to Period B in stage II (10% vs. 15%, p <.01) and III (70% vs. 79%, p <.01). Post-IDEA, the proportion of patients receiving ≤3 months of oxaliplatin-based AC increased (45% vs. 13%, p <.01). The proportion of patients who remained recurrence free at 3 years was similar between time periods in stage II (A: 89% vs. B: 88% vs. C: 90%, p =.53) and stage III (72% vs. 76% vs. 72%, p =.08). OS significantly improved for stage II (80%–85%, p =.04) and stage III (69%–77%, <.01) from period A to B. Conclusion: AC use has moderately decreased over time with no impact on recurrence rates. Improved survival in more recent years despite similar recurrence rates may be related to improved baseline staging, better postrecurrence treatment, and reduced noncancer-related mortality.
AB - Background: The administration of adjuvant chemotherapy (AC) to colorectal cancer (CRC) patients in Australia and impact of recent trial data has not been well reported. We aim to evaluate temporal trends in AC treatment and outcomes in real-world Australian patients. Methods: CRC patients were analyzed from 13 hospitals, stratified by stage (II or III) and three 5-year time periods (A: 2005–2009, B: 2010–2014, C: 2015–2019). Stage III was further stratified as pre- and post publication of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration (March 2018). AC prescription, time-to-recurrence (TTR), and overall survival (OS) was compared across the time periods. Results: Of 3977 identified patients, 1148 (stage II: 640, stage III: 508), 1525 (856 vs. 669), and 1304 (669 vs. 635) were diagnosed in Period A, B, and C, respectively. Fewer patients in Period C received AC compared to Period B in stage II (10% vs. 15%, p <.01) and III (70% vs. 79%, p <.01). Post-IDEA, the proportion of patients receiving ≤3 months of oxaliplatin-based AC increased (45% vs. 13%, p <.01). The proportion of patients who remained recurrence free at 3 years was similar between time periods in stage II (A: 89% vs. B: 88% vs. C: 90%, p =.53) and stage III (72% vs. 76% vs. 72%, p =.08). OS significantly improved for stage II (80%–85%, p =.04) and stage III (69%–77%, <.01) from period A to B. Conclusion: AC use has moderately decreased over time with no impact on recurrence rates. Improved survival in more recent years despite similar recurrence rates may be related to improved baseline staging, better postrecurrence treatment, and reduced noncancer-related mortality.
KW - adjuvant
KW - chemotherapy
KW - colorectal
KW - recurrence
KW - retrospective
UR - http://www.scopus.com/inward/record.url?scp=85143988266&partnerID=8YFLogxK
U2 - 10.1111/ajco.13885
DO - 10.1111/ajco.13885
M3 - Article
C2 - 36464923
AN - SCOPUS:85143988266
SN - 1743-7555
VL - 19
SP - 392
EP - 402
JO - Asia-Pacific Journal of Clinical Oncology
JF - Asia-Pacific Journal of Clinical Oncology
IS - 3
ER -