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- Title
Prognostic impact of interhospital variation in adjuvant chemotherapy for patients with Stage II/III colorectal cancer: a nationwide study.
- Authors
Arakawa, K.; Kawai, K.; Tanaka, T.; Hata, K.; Sugihara, K.; Nozawa, H.
- Abstract
Abstract: Aim: Clinical guidelines recommend adjuvant chemotherapy for high‐risk patients with Stage II–III colorectal cancer. However, chemotherapeutic administration rates differ significantly between hospitals. We assessed the prognostic benefit of adjuvant chemotherapy in patients with Stage IIb/c colorectal cancer, and the prognostic impact of interhospital variations in the administration of adjuvant chemotherapy for Stage II–III colorectal cancer. Method: We conducted a multicentre, retrospective study of 17 757 patients with Stage II–III colorectal cancer treated between 1997 and 2008 in 23 hospitals in Japan. Hospitals were classified as high‐rate (rate > 42.8%) or low‐rate (rate ≤ 42.8%), chemotherapy prescribing clinics. Results: The 5‐year overall survival (OS) of patients with Stage II–III colorectal cancer receiving adjuvant chemotherapy was significantly higher than for those not receiving adjuvant chemotherapy (85.7% vs 79.2%, P < 0.01 and 79.9% vs 72.5%, P < 0.01, respectively). For patients with Stage II disease, adjuvant chemotherapy was an independent factor for longer OS (P < 0.01, hazard ratio = 0.71). Both adjuvant chemotherapy and high‐rate hospital independently improved OS for patients with Stage III colorectal cancer (both P < 0.01; hazard ratio = 0.68 and 0.87, respectively). Conclusion: Significant prognostic benefit was found for patients with Stage IIb/c colorectal cancer who received adjuvant chemotherapy, with patients who were treated in hospitals with high adjuvant chemotherapy rates demonstrating better prognoses.
- Subjects
COLON cancer treatment; CANCER chemotherapy; CANCER prognosis; CANCER treatment; CANCER hospitals
- Publication
Colorectal Disease, 2018, Vol 20, Issue 7, pO162
- ISSN
1462-8910
- Publication type
Article
- DOI
10.1111/codi.14260