1. A population-based study of adjuvant chemotherapy for stage-II and -III colon cancers
- Author
-
Michel Velten, Simona Bara, Guy Launoy, Jean Faivre, Florence Molinié, Pascale Grosclaude, Brigitte Trétarre, J. M. Phelip, Patricia Delafosse, Olivier Ganry, Anne Marie Bouvier, A. Buemi, Arlette Danzon, Département d'Ingénierie des Systèmes (ex SIS) (DIS), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Cancer Registry of Isère, Registre des cancers du Bas-Rhin, CRLCC Paul Strauss, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Département d'Ingénierie des Systèmes (ex SIS) ( DIS ), Institut de Recherches sur les lois Fondamentales de l'Univers ( IRFU ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Université Paris-Saclay-Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Université Paris-Saclay, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), and Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO)
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Perforation (oil well) ,Population ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Adenocarcinoma ,Sampling Studies ,[ SDV.CAN ] Life Sciences [q-bio]/Cancer ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Stage (cooking) ,education ,Aged ,Aged, 80 and over ,Patient Care Team ,Chemotherapy ,education.field_of_study ,business.industry ,Age Factors ,Gastroenterology ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,3. Good health ,Surgery ,Clinical trial ,Chemotherapy, Adjuvant ,Intestinal Perforation ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Multivariate Analysis ,Population study ,Female ,France ,business ,Intestinal Obstruction - Abstract
Summary Background Although clinical trials have demonstrated that adjuvant chemotherapy improves survival for stage-III colon cancer, the benefits remain controversial for stage-II lesions. The objective of the present study was to determine the extent to which adjuvant chemotherapy is used for patients with stage-II and -III colon cancers. Methods The study population comprised 1074 patients with stage-II and -III colon cancers diagnosed in 2000 in 12 French administrative districts and recorded in population-based cancer registries. Data were collected using a standardized procedure. Results Overall, 20.4% of patients with stage II and 61.9% with stage III received adjuvant chemotherapy. Age at diagnosis was the strongest determinant of chemotherapy. Among stage-II patients, those receiving chemotherapy decreased from 57.6% in patients aged ≤ 50 years to 1.1% in those aged ≥ 85. The corresponding percentages with stage III were 93.6% and 1.4%. In multivariate analyses, other factors found to be independently and significantly associated with administration of adjuvant chemotherapy for stage II were extension of the cancer (stage IIA vs. stage IIB), clinical presentation (obstruction or perforation vs. uncomplicated cancer) and discussion of the case at a multidisciplinary case-review meeting. For stage III, apart from age, discussion of the case at a multidisciplinary meeting was the only factor independently associated with administration of chemotherapy. Conclusion Adjuvant chemotherapy for stage-III colon cancer is used extensively for patients under 75 years of age. However, many elderly patients do not receive such treatment. On the other hand, a substantial percentage of stage-II colon cancer patients receive adjuvant chemotherapy despite its uncertain benefits.
- Published
- 2010
- Full Text
- View/download PDF