Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/3166
Title: Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage III colon or stage II/III rectal cancer
Authors: Sarasqueta, C.
Perales, A.
Escobar, A.
Baré, M.
Redondo, M.
Fernández de Larrea, N.
Briones, E.
Piera, J. M.
Zunzunegui, M. V.
Quintana, J. M.
metadata.dc.contributor.authoraffiliation: [Sarasqueta,C; Perales,A] Biodonostia Health Research Institute - Donostia University Hospital / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Donostia-San Sebastián, Gipuzkoa, Spain. [Escobar,A] Research Unit, Hospital Basurto / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Bizkaia, Spain. [Baré,M] Clinical Epidemiology and Cancer Screening, Corporació Sanitaria Parc Taulí / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Sabadell, Barcelona, Spain. [Redondo,M] Research Unit, Costa del Sol Hospital / Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Marbella, Málaga, Spain. [Fernández de Larrea,N] Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III / Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. [Briones,E] Epidemiology Unit, Seville Health District, Andalusian Health Service / Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Seville, Spain. [Piera,JM] Medical Oncology Unit, Donostia University Hospital, Donostia-San Sebastián, Gipuzkoa, Spain. [Zunzunegui,MV] Departement de médecine sociale et préventive Institut de recherche en santé publique (IRSPUM), University of Montréal, Montréal, Québec, Canada. [Quintana,JM] Research Unit, Galdakao-Usansolo Hospital / REDISSEC, Labeaga Auzoa, 48960, Galdakao, Bizkaia, Spain.
metadata.dc.contributor.group: REDISECC-CARESS/CCR group
Keywords: Adherence;Age;Chemotherapy;Colorectal cancer;Equity;Preoperative radiotherapy;Quimioterapia;Drug therapy;Antineoplastic agents;Antineoplásicos;Neoplasias colorrectales;Colorectal neoplasms;Quimioterapia adyuvante
metadata.dc.subject.mesh: Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors
Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged::Aged, 80 and over
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy::Chemotherapy, Adjuvant
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures::Colectomy
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Colonic Neoplasms
Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy::Chemotherapy, Adjuvant
Medical Subject Headings::Persons::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy::Neoadjuvant Therapy
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Neoplasm Staging
Medical Subject Headings::Health Care::Health Services Administration::Quality of Health Care::Quality Assurance, Health Care::Guidelines as Topic::Practice Guidelines as Topic
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms
Medical Subject Headings::Anthropology, Education, Sociology and Social Phenomena::Social Sciences::Sociology::Socioeconomic Factors
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms
Issue Date: 25-Jul-2019
Publisher: BioMed Central Ltd
Citation: Sarasqueta C, Perales A, Escobar A, Baré M, Redondo M, Fernández de Larrea N, et al. Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage III colon or stage II/III rectal cancer. BMC Cancer. 2019 Jul 25;19(1):735.
Abstract: Background: Many older patients don't receive appropriate oncological treatment. Our aim was to analyse whether there are age differences in the use of adjuvant chemotherapy and preoperative radiotherapy in patients with colorectal cancer. Methods: A prospective cohort study was conducted in 22 hospitals including 1157 patients with stage III colon or stage II/III rectal cancer who underwent surgery. Primary outcomes were the use of adjuvant chemotherapy for stage III colon cancer and preoperative radiotherapy for stage II/III rectal cancer. Generalised estimating equations were used to adjust for education, living arrangements, area deprivation, comorbidity and clinical tumour characteristics. Results: In colon cancer 92% of patients aged under 65 years, 77% of those aged 65 to 80 years and 27% of those aged over 80 years received adjuvant chemotherapy (χ2trends < 0.001). In rectal cancer preoperative radiotherapy was used in 68% of patients aged under 65 years, 60% of those aged 65 to 80 years, and 42% of those aged over 80 years (χ2trends < 0.001). Adjusting by comorbidity level, tumour characteristics and socioeconomic level, the odds ratio of use of chemotherapy compared with those under age 65, was 0.3 (0.1-0.6) and 0.04 (0.02-0.09) for those aged 65 to 80 and those aged over 80, respectively; similarly, the odds ratio of use of preoperative radiotherapy was 0.9 (0.6-1.4) and 0.5 (0.3-0.8) compared with those under 65 years of age. Conclusions: The probability of older patients with colorectal cancer receiving adjuvant chemotherapy and preoperative radiotherapy is lower than that of younger patients; many of them are not receiving the treatments recommended by clinical practice guidelines. Differences in comorbidity, tumour characteristics, curative resection, and socioeconomic factors do not explain this lower probability of treatment. Research is needed to identify the role of physical and cognitive functional status, doctors' attitudes, and preferences of patients and their relatives, in the use of adjuvant therapies.
URI: http://hdl.handle.net/10668/3166
metadata.dc.relation.publisherversion: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-019-5910-z
metadata.dc.identifier.doi: 10.1186/s12885-019-5910-z
ISSN: 1471-2407 (Online)
Appears in Collections:01- Artículos - APES Costa del Sol

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