Evidence map›Paper›PMID 35648074›Full record

ArticleThe oncologist2022

Survival Outcomes of Adjuvant Chemotherapy in Elderly Patients with Stage III Colon Cancer.

Lana Khalil, Xingyu Gao, Jeffrey M Switchenko, Olatunji B Alese, Mehmet Akce, Christina Wu, Maria Diab, Bassel F El-Rayes, Walid L Shaib

Open access · goldAbstract read
In one paragraph

Article in The oncologist, 2022. 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.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. SEOM-GEMCAD-TTD clinical guidelines for the adjuvant treatment of colon cancer (2023).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024
    Guideline
  2. Article
  3. Article
  4. Article
  5. Review
  6. Guidance for Treating the Older Adults with Colorectal Cancer.Current treatment options in oncology · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Lana KhalilDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta GA, USA.ORCID 0000-0001-6396-1974
Xingyu GaoDepartment of Biostatistics, Emory University, Atlanta GA, USA.ORCID 0000-0002-5494-6139
Jeffrey M SwitchenkoDepartment of Biostatistics, Emory University, Atlanta GA, USA.
Olatunji B AleseDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta GA, USA.
Mehmet AkceDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta GA, USA.
Christina WuDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta GA, USA.
Maria DiabDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta GA, USA.
Bassel F El-RayesDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta GA, USA.
Walid L ShaibDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta GA, USA.
Emory University · US

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Suresh S Ramalingam · 2009 to 2026
$47.5M
NCI NIH HHS P30 CA138292
6 · The paper itself

Abstract

backgroundThe survival impact of multi-agent (MAC) compared with single-agent (SAC) adjuvant chemotherapy (AC) in elderly patients with stage III colon cancer (CC) remains controversial. The aim of this study was to compare survival outcomes of MAC and SAC in this population utilizing the National Cancer Database (NCDB). PATIENTS AND

methodsPatients aged ≥70 years with pathological stage III CC diagnosed in 2004-2015 were identified in the NCDB. Univariate and multivariable analyses were conducted, and Kaplan-Meier analysis and Cox proportional hazard models were used to identify associations between MAC vs. SAC and overall survival (OS).

resultsAmong 41 707 elderly patients (≥70 years old) with stage III CC, about half (n = 20 257; 48.5%) received AC; the majority (n = 12 923, 63.8%) received MAC. The median age was 79 (range 70-90). The majority were female (n = 11 201, 55.3%), Caucasians (88%) and had moderately differentiated tumor grade (n = 12 619, 62.3%), tumor size >4 cm (11 785, 58.2%), and negative surgical margins (18 496, 91.3%). Low-risk stage III CC constituted 50.6% (n = 10 264) of the study population. High-risk stage III CC was associated with worse OS compared with low-risk disease (HR 0.35, 0.34-0.36, P < .001). Multi-agent chemotherapy was associated with a better 5-year OS compared with SAC (P < .001). High-risk stage III patients who received MAC vs. SAC had an OS of 4.2 vs. 3.4 years, respectively (P < .001). Low-risk stage III patients who received MAC vs. SAC had a median OS of 8.5 vs. 7 years (P < .001). In univariate and multivariable analyses, male sex, positive surgical margin, insurance and facility types, age, year of diagnosis, tumor size, and Charlson-Deyo score of >2 were associated with worse OS (P < .05).

conclusionsAny adjuvant chemotherapy has a trend of survival benefits. Multi-agent chemotherapy seems to have an enhanced benefit in the 70-75 age group. Multi-agent chemotherapy seemed to have similar efficacy as SAC in those aged >76 years.

Indexed as

Colonic NeoplasmsAgedChemotherapy, AdjuvantFemaleHumansKaplan-Meier EstimateMaleMargins of ExcisionNeoplasm StagingProportional Hazards ModelsRetrospective Studiesabove 70agent chemotherapycolon cancerhigh riskmulti-agent chemotherapysinglestage IIIsurvival

Identifiers

PMID35648074
PMCPMC9438921
OpenAlexW4226353093

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.