Survival following early-stage colon cancer: an ACCENT-based comparison of patients versus a matched international general population†
| Autor: | L.A. Renfro, A. Grothey, D. Kerr, D.G. Haller, T. André, E. Van Cutsem, L. Saltz, R. Labianca, C.L. Loprinzi, S.R. Alberts, H. Schmoll, C. Twelves, G. Yothers, D.J. Sargent, E. Green, Q. Shi, M.J. O'Connell, N. Wolmark, A. de Gramont, R. Gray, K. Guthrie, M. Buyse, J.F. Seitz, C.J. O'Callaghan, G. Francini, P.J. Catalano, C.D. Blanke, T. Andre, R.M. Goldberg, A. Benson, F. Sirzen, L. Cisar |
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| Rok vydání: | 2014 |
| Předmět: |
Oncology
Male Time Factors Databases Factual Colorectal cancer Kaplan-Meier Estimate Risk Factors Stress (linguistics) Survivors Neoplasm Metastasis Early Detection of Cancer Randomized Controlled Trials as Topic Early-stage colon cancer education.field_of_study Individual patient data Long-term survival Meta-analysis Oxaliplatin chemotherapy Population Case-Control Studies Colonic Neoplasms Disease-Free Survival Female Humans Neoplasm Recurrence Local Neoplasm Staging Predictive Value of Tests Survival Rate Treatment Outcome Hematology Local Fluorouracil medicine.drug medicine.medical_specialty Stage colon cancer Databases Internal medicine medicine education Survival rate Factual business.industry Original Articles medicine.disease Oxaliplatin Surgery Neoplasm Recurrence business |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology. 26(5) |
| ISSN: | 1569-8041 |
| Popis: | Post-treatment survival experience of early colon cancer (CC) patients is well described in the literature, which states that cure is probable for some patients. However, comparisons of treated patients' survival versus that expected from a matched general population (MGP) are limited.A total of 32 745 patients from 25 randomized adjuvant trials conducted from 1977 to 2012 in 41 countries were pooled. Observed long-term survival of these patients was compared with expected survival matched on sex, age, country, and year, both overall and by stage (II and III), sex, treatment [surgery, 5-fluorouracil (5-FU), 5-FU + oxaliplatin], age (70 and 70+), enrollment year (pre/post 2000), and recurrence (yes/no). Comparisons were made at randomization and repeated conditional on survival to 1, 2, 3, and 5 years. CC and MGP equivalence was tested, and observed Kaplan-Meier survival rates compared with expected MGP rates 3 years out from each landmark. Analyses were also repeated in patients without recurrence.Within most cohorts, long-term survival of CC patients remained statistically worse than the MGP, though conditional survival generally improved over time. Among those surviving 5 years, stage II, oxaliplatin-treated, elderly, and recurrence-free patients achieved subsequent 3-year survival rates within 5% of the MGP, with recurrence-free patients achieving equivalence.Conditional on survival to 5 years, long-term survival of most CC patients on clinical trials remains modestly poorer than an MGP, but achieves MGP levels in some subgroups. These findings emphasize the need for access to quality care and improved treatment and follow-up strategies. |
| Databáze: | OpenAIRE |
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