The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.

<h4>Background</h4>Delayed chemotherapy is associated with inferior survival in stage III colon and stage II/III rectal cancer patients, but similar studies have not been performed in stage II colon cancer patients. We investigate the association between delayed and incomplete chemothera...

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Autores principales:	Fang Xu, Alfred A Rimm, Pingfu Fu, Smitha S Krishnamurthi, Gregory S Cooper
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e732fe8fbaa440e3a36acc08de2cb28c
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spelling	oai:doaj.org-article:e732fe8fbaa440e3a36acc08de2cb28c2021-11-25T05:59:58ZThe impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.1932-620310.1371/journal.pone.0107993https://doaj.org/article/e732fe8fbaa440e3a36acc08de2cb28c2014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0107993https://doaj.org/toc/1932-6203<h4>Background</h4>Delayed chemotherapy is associated with inferior survival in stage III colon and stage II/III rectal cancer patients, but similar studies have not been performed in stage II colon cancer patients. We investigate the association between delayed and incomplete chemotherapy, and the association of delayed chemotherapy with survival in stage II colon cancer patients.<h4>Patients and methods</h4>Patients (age ≥ 66) diagnosed as stage II colon cancer and received chemotherapy from 1992 to 2005 were identified from the linked SEER-Medicare database. The association between delayed and incomplete chemotherapy was assessed using unconditional and conditional logistic regressions. Survival outcomes were assessed using stratified Cox regression based on propensity score matched samples.<h4>Results</h4>4,209 stage II colon cancer patients were included, of whom 73.0% had chemotherapy initiated timely (≤ 2 months after surgery), 14.7% had chemotherapy initiated with moderate delay (2-3 months), and 12.3% had delayed chemotherapy (≥ 3 months). Delayed chemotherapy was associated with not completing chemotherapy (adjusted odds ratio (OR): 1.33 (95% confidence interval: 1.11, 1.59) for moderately delayed group, adjusted OR: 2.60 (2.09, 3.24) for delayed group). Delayed chemotherapy was associated with worse survival outcomes (hazard ratio (HR): 1.75 (1.29, 2.37) for overall survival; HR: 4.23 (2.19, 8.20) for cancer-specific survival).<h4>Conclusion</h4>Although the benefit of chemotherapy is unclear in stage II colon cancer patients, delay in initiation of chemotherapy is associated with an incomplete chemotherapy course and poorer survival, especially cancer-specific survival. Causal inference in the association between delayed initiation of chemotherapy and inferior survival requires further investigation.Fang XuAlfred A RimmPingfu FuSmitha S KrishnamurthiGregory S CooperPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 9, p e107993 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Fang Xu Alfred A Rimm Pingfu Fu Smitha S Krishnamurthi Gregory S Cooper The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.
description	<h4>Background</h4>Delayed chemotherapy is associated with inferior survival in stage III colon and stage II/III rectal cancer patients, but similar studies have not been performed in stage II colon cancer patients. We investigate the association between delayed and incomplete chemotherapy, and the association of delayed chemotherapy with survival in stage II colon cancer patients.<h4>Patients and methods</h4>Patients (age ≥ 66) diagnosed as stage II colon cancer and received chemotherapy from 1992 to 2005 were identified from the linked SEER-Medicare database. The association between delayed and incomplete chemotherapy was assessed using unconditional and conditional logistic regressions. Survival outcomes were assessed using stratified Cox regression based on propensity score matched samples.<h4>Results</h4>4,209 stage II colon cancer patients were included, of whom 73.0% had chemotherapy initiated timely (≤ 2 months after surgery), 14.7% had chemotherapy initiated with moderate delay (2-3 months), and 12.3% had delayed chemotherapy (≥ 3 months). Delayed chemotherapy was associated with not completing chemotherapy (adjusted odds ratio (OR): 1.33 (95% confidence interval: 1.11, 1.59) for moderately delayed group, adjusted OR: 2.60 (2.09, 3.24) for delayed group). Delayed chemotherapy was associated with worse survival outcomes (hazard ratio (HR): 1.75 (1.29, 2.37) for overall survival; HR: 4.23 (2.19, 8.20) for cancer-specific survival).<h4>Conclusion</h4>Although the benefit of chemotherapy is unclear in stage II colon cancer patients, delay in initiation of chemotherapy is associated with an incomplete chemotherapy course and poorer survival, especially cancer-specific survival. Causal inference in the association between delayed initiation of chemotherapy and inferior survival requires further investigation.
format	article
author	Fang Xu Alfred A Rimm Pingfu Fu Smitha S Krishnamurthi Gregory S Cooper
author_facet	Fang Xu Alfred A Rimm Pingfu Fu Smitha S Krishnamurthi Gregory S Cooper
author_sort	Fang Xu
title	The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.
title_short	The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.
title_full	The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.
title_fullStr	The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.
title_full_unstemmed	The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.
title_sort	impact of delayed chemotherapy on its completion and survival outcomes in stage ii colon cancer patients.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/e732fe8fbaa440e3a36acc08de2cb28c
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The impact of delayed chemotherapy on its completion and survival outcomes in stage II colon cancer patients.

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