ArticleTherapeutic advances in medical oncology2021
The association of comorbidities with administration of adjuvant chemotherapy in stage III colon cancer patients: a systematic review and meta-analysis.
Article in Therapeutic advances in medical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Efficacy and safety of oral 5-FU-based adjuvant chemotherapy for geriatric patients with colorectal cancer: Integrated analysis of seven clinical trials conducted at the Japanese Foundation for Multidisciplinary Treatment of Cancer.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- The prognostic and predictive significance of perineural invasion in stage I to III colon cancer: a propensity score matching-based analysis.World journal of surgical oncology · 2024Article
- Associations Between Patient Experience With Care, Race and Ethnicity, and Receipt of CRC Treatment Among SEER-CAHPS Patients With Multiple Comorbidities.Journal of the National Comprehensive Cancer Network : JNCCN · 2023Article
- Comorbidity Patterns in Patients Newly Diagnosed With Colorectal Cancer: Network-Based Study.JMIR public health and surveillance · 2023Observational
- Variations in colorectal cancer pattern of care by age and comorbidity in South Australia.Cancer medicine · 2023Article
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5 authors.
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Abstract
backgroundChemotherapy is an established treatment for stage III colon cancer cases. Older age is known to be associated with less chemotherapy use in these patients, but there might be other relevant factors besides age that influence treatment administration. We summarized evidence on associations between comorbidity and adjuvant chemotherapy administration in stage III colon cancer patients in a systematic review and meta-analysis.
methodsWe searched the PubMed and Web of Science databases up to 2 June 2020 for studies on comorbidities and chemotherapy use in patients with stage III colon cancer. Summary odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using random-effects models. Subgroup analyses according to year of colon cancer diagnosis, timing of comorbidity assessment, and geographical region were also conducted.
resultsThirty-three studies were included in this review, including 219,406 stage III colon cancer patients overall. Chemotherapy administration was 60.9% (95% CI: 56.9% to 64.9%), increasing from 57.1% before 2001 to 66.3% after 2010. There were inverse associations between comorbidities and chemotherapy administration. Compared with patients with Charlson comorbidity score 0, those with scores 1 (OR = 0.79, 95% CI = 0.72-0.87) and 2+ (OR = 0.49, 95% CI = 0.42-0.56) received chemotherapy less often. Among comorbidities, the strongest predictors of chemotherapy non-use were dementia (OR = 0.37, 95% CI = 0.33-0.54), followed by heart failure (OR = 0.44, 95% CI = 0.28-0.70) and stroke (OR = 0.56, 95% CI = 0.38-0.81).
conclusionsMerely 60% of stage III colon cancer patients receive chemotherapy. Comorbidities are strong predictors of chemotherapy non-use, but the association differs by comorbid condition and is strongest with dementia. Given the survival disadvantage of colon cancer patients with comorbidities, further evidence on the risk-benefit ratio of chemotherapy according to the type and severity of comorbidity and on the extent to which the survival disadvantage of comorbidity is explained by less use or lower tolerability of chemotherapy is needed to foster personalized medical care in these patients.
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