Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage III colon or stage II/III rectal cancer

Autor: C. Sarasqueta, A. Perales, A. Escobar, M. Baré, M. Redondo, N. Fernández de Larrea, E. Briones, J. M. Piera, M. V. Zunzunegui, J. M. Quintana, the REDISECC-CARESS/CCR group
Přispěvatelé: Instituto de Salud Carlos III, Basque Government (España), Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), REDISECC-CARESS/CCR group, [Sarasqueta,C, Perales,A] Biodonostia Health Research Institute - Donostia University Hospital / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Donostia-San Sebastián, Gipuzkoa, Spain. [Escobar,A] Research Unit, Hospital Basurto / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Bizkaia, Spain. [Baré,M] Clinical Epidemiology and Cancer Screening, Corporació Sanitaria Parc Taulí / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Sabadell, Barcelona, Spain. [Redondo,M] Research Unit, Costa del Sol Hospital / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Marbella, Málaga, Spain. [Fernández de Larrea,N] Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III / Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. [Briones,E] Epidemiology Unit, Seville Health District, Andalusian Health Service / Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Seville, Spain. [Piera,JM] Medical Oncology Unit, Donostia University Hospital, Donostia-San Sebastián, Gipuzkoa, Spain. [Zunzunegui,MV] Departement de médecine sociale et préventive Institut de recherche en santé publique (IRSPUM), University of Montréal, Montréal, Québec, Canada. [Quintana,JM] Research Unit, Galdakao-Usansolo Hospital / REDISSEC, Labeaga Auzoa, 48960, Galdakao, Bizkaia, Spain., Eusko Jaurlaritza, European Commission
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Cancer Research
Colorectal cancer
medicine.medical_treatment
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy::Chemotherapy
Adjuvant [Medical Subject Headings]
Quimioterapia adyuvante
Comorbidity
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy::Neoadjuvant Therapy [Medical Subject Headings]
Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]
0302 clinical medicine
Neoplasias colorrectales
Surgical oncology
Health Care::Health Care Quality
Access
and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [Medical Subject Headings]
Antineoplastic agents
Medicine
Prospective Studies
Stage (cooking)
Prospective cohort study
Colectomy
Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings]
Aged
80 and over
Proctectomy
Health Care::Health Care Quality
Access
and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors [Medical Subject Headings]
Age Factors
Equity
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Neoadjuvant Therapy
Oncology
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Colonic Neoplasms
Practice Guidelines as Topic
Female
Drug therapy
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Neoplasm Staging [Medical Subject Headings]
Colorectal Neoplasms
Adjuvant
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures
Operative::Digestive System Surgical Procedures::Colectomy [Medical Subject Headings]
Research Article
medicine.medical_specialty
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings]
lcsh:RC254-282
Health Care::Health Services Administration::Quality of Health Care::Quality Assurance
Health Care::Guidelines as Topic::Practice Guidelines as Topic [Medical Subject Headings]
03 medical and health sciences
Age
Genetics
Anthropology
Education
Sociology and Social Phenomena::Social Sciences::Sociology::Socioeconomic Factors [Medical Subject Headings]
Chemotherapy
Humans
Aged
Neoplasm Staging
Rectal Neoplasms
business.industry
Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings]
Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings]
Odds ratio
Antineoplásicos
medicine.disease
Surgery
030104 developmental biology
Check Tags::Female [Medical Subject Headings]
Socioeconomic Factors
Persons::Persons::Age Groups::Adult::Aged::Aged
80 and over [Medical Subject Headings]
Adherence
Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Colonic Neoplasms [Medical Subject Headings]
Quimioterapia
business
Preoperative radiotherapy
Zdroj: Repisalud
Instituto de Salud Carlos III (ISCIII)
BMC Cancer, Vol 19, Iss 1, Pp 1-15 (2019)
BMC Cancer
Digital.CSIC. Repositorio Institucional del CSIC
instname
ISSN: 1471-2407
Popis: Consortia: The REDISECC-CARESS/CCR group: Jose María Quintana, Marisa Baré, Maximino Redondo, Eduardo Briones Pérez de la Briones, Nerea Fernández de Larrea, Cristina Sarasqueta, Antonio Escobar , Francisco Rivas, Maria Morales-Suárez, Juan Antonio Blasco, Isabel del Cura , Inmaculada Arostegui, Amaia Bilbao, Nerea González , Susana García-Gutiérrez, Iratxe Lafuente, Urko Aguirre, Miren Orive, Josune Martin, Ane Antón-Ladislao, Núria Torà, Marina Pont, María Purificación Martínez del, Alberto Loizate, Ignacio Zabalza, José Errasti, Antonio Gimeno, Santiago Lázaro, Mercè Comas, Jose María Enríquez-Navascues, Carlos Placer, Amaia Perales, Iñaki Urkidi, Jose María Erro, Enrique Cormenzana, Adelaida Lacasta, Pep Piera, Elena Campano, Ana Isabel Sotelo, Segundo Gómez-Abril, F. Medina-Cano, Julia Alcaide, Arturo Del Rey-Moreno, Manuel Jesús Alcántara, Rafael Campo, Alex Casalots, Carles Pericay, Maria José Gil, Miquel Pera, Pablo Collera, Josep Alfons Espinàs, Mercedes Martínez, Mireia Espallargues, Caridad Almazán, Paula Dujovne, José María Fernández-Cebrián, Rocío Anula, Julio Mayol, Ramón Cantero, Héctor Guadalajara, María Alexandra Heras, Damián García, Mariel Morey & Alberto Colina.
[Background]: Many older patients don’t receive appropriate oncological treatment. Our aim was to analyse whether there are age differences in the use of adjuvant chemotherapy and preoperative radiotherapy in patients with colorectal cancer.
[Methods]: A prospective cohort study was conducted in 22 hospitals including 1157 patients with stage III colon or stage II/III rectal cancer who underwent surgery. Primary outcomes were the use of adjuvant chemotherapy for stage III colon cancer and preoperative radiotherapy for stage II/III rectal cancer. Generalised estimating equations were used to adjust for education, living arrangements, area deprivation, comorbidity and clinical tumour characteristics.
[Results]: In colon cancer 92% of patients aged under 65 years, 77% of those aged 65 to 80 years and 27% of those aged over 80 years received adjuvant chemotherapy (χ2trends
[Conclusions]: The probability of older patients with colorectal cancer receiving adjuvant chemotherapy and preoperative radiotherapy is lower than that of younger patients; many of them are not receiving the treatments recommended by clinical practice guidelines. Differences in comorbidity, tumour characteristics, curative resection, and socioeconomic factors do not explain this lower probability of treatment. Research is needed to identify the role of physical and cognitive functional status, doctors’ attitudes, and preferences of patients and their relatives, in the use of adjuvant therapies.
This work was supported in part by grants from the Spanish Health Research Fund (PS09/00314, PS09/00910, PS09/00746, PS09/00805, PI09/90460, PI09/90490, PI09/90397, PI09/90453, PI09/90441); Department of Health of the Basque Country (2010111098); KRONIKGUNE–Research Centre on Chronicity (KRONIK 11/006); and the European Regional Development Fund.
Databáze: OpenAIRE
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