SynthesisJournal of the National Cancer Institute2011
Outcomes among black patients with stage II and III colon cancer receiving chemotherapy: an analysis of ACCENT adjuvant trials.
Synthesis in Journal of the National Cancer Institute, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00002593 (Phase III Randomized Trial of 5-FU/Leucovorin/Levamisole Versus 5-FU Continuous Infusion/Levamisole as Adjuvant Therapy for High-Risk Resectable Colon Cancer), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Phase III Randomized Trial of 5-FU/Leucovorin/Levamisole Versus 5-FU Continuous Infusion/Levamisole as Adjuvant Therapy for High-Risk Resectable Colon Cancer
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- Can population differences in chemotherapy outcomes be inferred from differences in pharmacogenetic frequencies?The pharmacogenomics journal · 2013Pooled it
- Trial
- Risk of late recurrence of colorectal and breast cancer among older long-term cancer survivors.JNCI cancer spectrum · 2026Article
- Colorectal Cancer: Differential Gene Expression and In Vitro Response to 5-Fluorouracil, Novel Fluoropyrimidine F10, and Potential Synergy with Lupeol.International journal of molecular sciences · 2025Article
- Black-White disparities across the colorectal cancer care continuum in the USA.Nature reviews. Gastroenterology & hepatology · 2025Review
- Assessing Racial Disparities in Guideline-Concordant Care and Clinical Outcomes after Surgical Resection of Nonmetastatic Colon Cancer at a Comprehensive Cancer Center.Cancer research communications · 2025Article
- Landscape and Saturation Analysis of Mutations Associated With Race in Cancer Genomes by Clinical Sequencing.The oncologist · 2024Article
- Molecular disparities in colorectal cancers of White Americans, Alabama African Americans, and Oklahoma American Indians.NPJ precision oncology · 2023Article
- Underutilization of Guideline-Recommended Mismatch Repair/Microsatellite Instability Biomarker Testing in Advanced Colorectal Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Healthcare Disparities and Colorectal Cancer.Surgical oncology clinics of North America · 2022Review
- Modeling the Cost-Effectiveness of Adjuvant Chemotherapy for Stage III Colon Cancer in South African Public Hospitals.JCO global oncology · 2021Article
- Article
- Racial Disparities in Recurrence and Overall Survival in Patients With Locoregional Colorectal Cancer.Journal of the National Cancer Institute · 2021Article
- Racial and geographic disparities in stage-specific incidence and mortality in the colorectal cancer hotspot region of eastern North Carolina, 2008-2016.Cancer causes & control : CCC · 2021Article
- The Role of Gut Barrier Dysfunction and Microbiome Dysbiosis in Colorectal Cancer Development.Frontiers in oncology · 2021Review
- Intestinal bacteria detected in cancer and adjacent tissue from patients with colorectal cancer.Oncology letters · 2019Article
- Racial disparity in colorectal cancer: Gut microbiome and cancer stem cells.World journal of stem cells · 2016Review
- Leveraging the power of pooled data for cancer outcomes research.Chinese journal of cancer · 2016Article
- Racial/Ethnic Disparities in Survival Among Patients With Young-Onset Colorectal Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2016Article
- Colorectal cancer survival in Jamaica.Annals of medicine and surgery (2012) · 2016Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundAmong patients with resected colon cancer, black patients have worse survival than whites. We investigated whether disparities in survival and related endpoints would persist when patients were treated with identical therapies in controlled clinical trials.
methodsWe assessed 14,611 patients (1218 black and 13,393 white) who received standardized adjuvant treatment in 12 randomized controlled clinical trials conducted in North America for resected stage II and stage III colon cancer between 1977 and 2002. Individual patient data on covariates and outcomes were extracted from the Adjuvant Colon Cancer ENdpoinTs (ACCENT) database. The endpoints examined in this meta-analysis were overall survival (time to death), recurrence-free survival (time to recurrence or death), and recurrence-free interval (time to recurrence). Cox models were stratified by study and controlled for sex, stage, age, and treatment to determine the effect of race. Kaplan-Meier estimates were adjusted for similar covariates to control for confounding. All statistical tests were two-sided.
resultsBlack patients were younger than whites (median age, 58 vs 61 years, respectively; P < .001) and more likely to be female (55% vs 45%, respectively; P < .001). Overall survival was worse in black patients than whites (hazard ratio [HR] of death = 1.22, 95% confidence interval [CI] = 1.11 to 1.34, P < .001). Five-year overall survival rates for blacks and whites were 68.2% and 72.8%, respectively. When subsets defined by sex, stage, and age were analyzed, overall survival was consistently worse in black patients. Recurrence-free survival was worse in black patients than whites (HR of recurrence or death = 1.14, 95% CI = 1.04 to 1.24, P = .0045). Three-year recurrence-free survival rates in blacks and whites were 68.4% and 72.1%, respectively. In contrast, recurrence-free interval was similar in black and white patients (HR of recurrence = 1.08, 95% CI = 0.97 to 1.19, P = .15). Three-year recurrence-free interval rates in blacks and whites were 71.3% and 74.2%, respectively.
conclusionsBlack patients with resected stage II and stage III colon cancer who were treated with the same therapy as white patients experienced worse overall and recurrence-free survival, but similar recurrence-free interval, compared with white patients. The differences in survival may be mostly because of factors unrelated to the patients' adjuvant colon cancer treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.