Researchers from Switzerland evaluated the use and benefit of adjuvant chemotherapy for lymph-node-positive (stage III) colon carcinoma (CC), in routine health care practice.
All patients with stage III CC, treated by putative curative surgery (n = 182) recorded at the Geneva cancer registry between 1990 and 1996, were included in the study.
Factors modifying chemotherapy use were determined by logistic regression. Patients with chemotherapy were considered as cases (n = 55) and others as controls (n = 127).
The Cox model was used to evaluate the effect of chemotherapy on 5-year survival rates. Analyses were adjusted for possible confounders.
The researchers found that the use of chemotherapy increased over the study period.
| Adjuvant chemotherapy for stage III colon carcinoma not optimally utilized in elderly.
| British Journal of Cancer |
Age strongly modulated chemotherapy use. In 1996, 54% of eligible patients received chemotherapy. However, this proportion fell to 13% after age 70.
Decisions to use chemotherapy significantly depended on stage, grade, and cancer site.
The chance to be treated was non-significantly lower among individuals of low social class, those widowed, and foreigners.
Chemotherapy was found to significantly decrease mortality rates (Hazard ratio: 0.35), independently of the prognostic factors, and with similar benefit regardless of stage and age group.
Author C. Bouchardy concluded on behalf of fellow colleagues, "Strong beneficial effect of adjuvant chemotherapy on stage III colon carcinoma can be achieved in routine practice.
"However, this study shows that it is probably not optimally utilized in Switzerland, particularly among the elderly."