Timeliness of adjuvant chemotherapy for stage III adenocarcinoma of the colon

A measure of quality of care

Steven Yu, Maryam Shabihkhani, Dongyun Yang, Eddie Thara, Anthony Senagore, Heinz Josef Lenz, Sarmad Sadeghi, Afsaneh Barzi

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background Findings 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 Methods We 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. Results We 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. Conclusion To 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.

Original languageEnglish (US)
Pages (from-to)275-279
Number of pages5
JournalClinical Colorectal Cancer
Volume12
Issue number4
DOIs
StatePublished - 2013
Externally publishedYes

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Quality of Health Care
Adjuvant Chemotherapy
Colonic Neoplasms
Colon
Adenocarcinoma
Recurrence
County Hospitals
Los Angeles
Standard of Care
Patient Care
Clinical Trials

Keywords

  • Adjuvant therapy
  • Affordable Care Act
  • Colon cancer
  • Quality measure
  • Racial disparities

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Timeliness of adjuvant chemotherapy for stage III adenocarcinoma of the colon : A measure of quality of care. / Yu, Steven; Shabihkhani, Maryam; Yang, Dongyun; Thara, Eddie; Senagore, Anthony; Lenz, Heinz Josef; Sadeghi, Sarmad; Barzi, Afsaneh.

In: Clinical Colorectal Cancer, Vol. 12, No. 4, 2013, p. 275-279.

Research output: Contribution to journalArticle

Yu, S, Shabihkhani, M, Yang, D, Thara, E, Senagore, A, Lenz, HJ, Sadeghi, S & Barzi, A 2013, 'Timeliness of adjuvant chemotherapy for stage III adenocarcinoma of the colon: A measure of quality of care', Clinical Colorectal Cancer, vol. 12, no. 4, pp. 275-279. https://doi.org/10.1016/j.clcc.2013.08.002
Yu, Steven ; Shabihkhani, Maryam ; Yang, Dongyun ; Thara, Eddie ; Senagore, Anthony ; Lenz, Heinz Josef ; Sadeghi, Sarmad ; Barzi, Afsaneh. / Timeliness of adjuvant chemotherapy for stage III adenocarcinoma of the colon : A measure of quality of care. In: Clinical Colorectal Cancer. 2013 ; Vol. 12, No. 4. pp. 275-279.
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AU - Yu, Steven

AU - Shabihkhani, Maryam

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AU - Thara, Eddie

AU - Senagore, Anthony

AU - Lenz, Heinz Josef

AU - Sadeghi, Sarmad

AU - Barzi, Afsaneh

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N2 - Background Findings 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 Methods We 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. Results We 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. Conclusion To 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.

AB - Background Findings 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 Methods We 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. Results We 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. Conclusion To 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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