Timeliness of Adjuvant Chemotherapy for Stage III Adenocarcinoma of the Colon: A Measure of Quality of Care |
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Authors: | Steven Yu Maryam Shabihkhani Dongyun Yang Eddie Thara Anthony Senagore Heinz-Josef Lenz Sarmad Sadeghi Afsaneh Barzi |
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Institution: | 1. Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan 430071, China;2. Division of Hepatobiliary Surgery, Department of Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China;1. Department of Science for Woman and Child Health, University of Florence, Florence, Italy;2. Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy;3. The Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, New York, NY, United States |
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Abstract: | BackgroundFindings from multiple clinical trials established AC as a standard of care for stage III colon cancer. However, there is no recommended standard time for delivery of AC. We explored the timeliness of AC with FOLFOX as a predictor of recurrence and its role as a quality indicator in patients with stage III colon cancer.Patients and MethodsWe conducted a retrospective analysis of patients with colon cancer who received AC at Los Angeles County Hospital and Norris Cancer Center between 2003 and 2011. Time to recurrence (TTR) was the primary end point of the study, Kaplan-Meier curves and log-rank tests were used to assess the association between timing of the AC and TTR.ResultsWe identified 102 patients with stage III colon cancer who had received AC. With a median follow-up of 3.2 years, time from surgery to AC was not a predictor of recurrence (P = .19). However, there was a nonsignificant trend toward higher risk of systemic recurrence when the delay of AC was more than 12 weeks (P = .068). Additionally, a significant association was found between age, race, type of hospital, and timeliness of AC.ConclusionTo date, our study is the largest data set to assess the timeliness of FOLFOX as a predictor of outcome in stage III colon cancer. Because FOLFOX is the current standard for AC for colon cancer, we report a trend toward worse outcome when FOLFOX is delayed more than 12 weeks. This result, thus supports quality measures to assess the timeliness of AC in stage III colon cancer and might have a meaningful effect on the care of patients with colon cancer. |
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Keywords: | Adjuvant therapy Affordable Care Act Colon cancer Quality measure Racial disparities |
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