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Titolo:
Variations in the use of adjuvant chemotherapy for node-positive colon cancer in the elderly: A population-based study
Autore:
Sundararajan, V; Grann, VR; Jacobson, JS; Ahsan, H; Neugut, AI;
Indirizzi:
Joseph L Mailman Sch Publ Hlth, Div Epidemiol, New York, NY 10032 USA Joseph L Mailman Sch Publ Hlth New York NY USA 10032 w York, NY 10032 USA Columbia Univ, Coll Phys & Surg, Herbert Irving Comprehens Can Ctr, New York, NY USA Columbia Univ New York NY USA rving Comprehens Can Ctr, New York, NY USA Columbia Univ, Coll Phys & Surg, Dept Med, New York, NY USA Columbia UnivNew York NY USA ll Phys & Surg, Dept Med, New York, NY USA
Titolo Testata:
CANCER JOURNAL
fascicolo: 3, volume: 7, anno: 2001,
pagine: 213 - 218
SICI:
1528-9117(200105/06)7:3<213:VITUOA>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROSTATE-CANCER; OVARIAN-CANCER; BREAST-CANCER; LUNG-CANCER; AGE; PATTERNS; CARE; COMORBIDITY; CARCINOMA; SURVIVAL;
Keywords:
colon neoplasms; drug therapy; mortality; chemotherapy; logistic models; Medicare; SEER Program; epidemiology; adjuvant therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Neugut, AI Joseph L Mailman Sch Publ Hlth, Div Epidemiol, PH-18-127,630 W 168th St, New York, NY 10032 USA Joseph L Mailman Sch Publ Hlth PH-18-127,630 W 168th St New York NY USA 10032
Citazione:
V. Sundararajan et al., "Variations in the use of adjuvant chemotherapy for node-positive colon cancer in the elderly: A population-based study", CANCER J, 7(3), 2001, pp. 213-218

Abstract

BACKGROUNDSince 1990, the recommended adjuvant therapy for patients with surgically resected node-positive colon cancer has been 5-fluorouracil (5-FU), usuallyin combination with leucovorin or levamisole. The purpose of this study isto assess the distribution of adjuvant 5-FU treatment in the elderly. METHODSThe Surveillance, Epidemiology and End Results-Medicare database provides population-based information on cancer patients, representing approximately14% of the United States population, along with health care utilization data from Medicare claims files. We studied patients with node-positive coloncancer diagnosed between 1992 and 1996 who survived at least 120 days beyond diagnosis (N = 4998). RESULTSAbout 50% of elderly patients received 5-FU within 4 months of diagnosis. The proportion of patients treated with 5-FU increased by about 10% from 1992 to 1996. in a multiple logistic regression model, 5-FU treatment was less likely to be given to older patients (compared with those aged 65-69 years, the odds ratio (OR) [95% Cl] was 0.82 [0.67-1.00] for ages 70 to 74 years, 0.47 [0.39-0.57] for ages 75 to 79, 0.17 [0.13-0.20] for ages 80 to 84, and 0.04 [0.03-0.05] for ages 85 to 88 years. Non-Hispanic black patients were less likely to be treated than non-Hispanic white patients (OR 0.46 [0.36-0.59]); patients with more than three positive lymph nodes were more likely to be treated than those with three or less, and those with comorbid conditions were less likely to be treated than those without such conditions. CONCLUSIONSDespite its proven efficacy in reducing colon cancer mortality, 5-FU-basedchemotherapy is not widely used among apparently eligible patients over age 65. Efforts are needed to ensure that elderly and non-Hispanic black patients receive appropriate treatment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/02/20 alle ore 02:29:55