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ndltd-OhioLink-oai-etd.ohiolink.edu-case1301597202
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oai_dc
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ndltd-OhioLink-oai-etd.ohiolink.edu-case13015972022021-08-03T05:34:10Z Practice Pattern of Adjuvant Therapy Use in Resectable Colorectal Cancer, A Population Based Study Xu, Fang <p>Colorectal cancer is a leading cancer in both men and women. The role of adjuvant therapy is to reduce the risk of cancer recurrence. There are limited population-based studies investigating patterns of use of adjuvant therapy in resectable colorectal cancer in the routine practice. The study included three components. First, combined chemoradiation therapy is a recommended treatment for stage II and III rectal cancer patients. The actual pattern of neoadjuvant chemoradiation use outside clinical trial settings has not been well studied using population-based data. The patient characteristics associated with the use of neoadjuvant chemoradiation and its recent temporal trend were described. Second, chemotherapy is only recommended to high-risk stage II colon cancer patients. The association between patient characteristics and the use of chemotherapy in these patients was examined. As one of the high-risk prognostic factors, low-count lymph node was thought to be correlated with understaging. The survival outcomes comparing those who did and didn’t receive chemotherapy in patients with low-, median-, high-count lymph node was sought to test the association. Third, it is unknown whether or not delayed chemotherapy could affect incompletion of chemotherapy. No study has investigated the impact of delayed chemotherapy on survival outcome modified by chemotherapy completion among stage II colon cancer patients given the unclear benefit of chemotherapy in this population. The overall goal of the study is to understand the utilization pattern of adjuvant therapy in the elderly population having colorectal cancer in US so that the message conveyed by the data will help health policy makers improve treatment care to the elderly cancer patients. </p><p>In Aim 1, during the study period, there was an increasing temporal trend of using neoadjuvant chemoradiation, but no clear pattern of patient characteristics was identified. In Aim 2, the dominant risk factors associated with receiving chemotherapy were T4 lesion, perforation and increasing number of high-risk factors. Low-count lymph node was not correlated with understaging. The findings in Aim 3 revealed that delayed initiation of chemotherapy was associated with incomplete chemo regimen, inferior overall and cancer-specific survivals among stage II colon cancer patients.</p> 2011 English text Case Western Reserve University School of Graduate Studies / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=case1301597202 http://rave.ohiolink.edu/etdc/view?acc_num=case1301597202 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
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NDLTD
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| language |
English
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NDLTD
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| author |
Xu, Fang
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| spellingShingle |
Xu, Fang
Practice Pattern of Adjuvant Therapy Use in Resectable Colorectal Cancer, A Population Based Study
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| author_facet |
Xu, Fang
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| author_sort |
Xu, Fang
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| title |
Practice Pattern of Adjuvant Therapy Use in Resectable Colorectal Cancer, A Population Based Study
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| title_short |
Practice Pattern of Adjuvant Therapy Use in Resectable Colorectal Cancer, A Population Based Study
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| title_full |
Practice Pattern of Adjuvant Therapy Use in Resectable Colorectal Cancer, A Population Based Study
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| title_fullStr |
Practice Pattern of Adjuvant Therapy Use in Resectable Colorectal Cancer, A Population Based Study
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| title_full_unstemmed |
Practice Pattern of Adjuvant Therapy Use in Resectable Colorectal Cancer, A Population Based Study
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| title_sort |
practice pattern of adjuvant therapy use in resectable colorectal cancer, a population based study
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| publisher |
Case Western Reserve University School of Graduate Studies / OhioLINK
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| publishDate |
2011
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| url |
http://rave.ohiolink.edu/etdc/view?acc_num=case1301597202
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AT xufang practicepatternofadjuvanttherapyuseinresectablecolorectalcancerapopulationbasedstudy
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| _version_ |
1719421832692498432
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