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Cited by 481

The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.

Age and Adjuvant Chemotherapy Use After Surgery for Stage III Colon Cancer

Schrag, D., Cramer, L. D., Bach, P. B., Begg, C. B.·2001·JNCI Journal of the National Cancer Institute

Abstract

BACKGROUND: Randomized trials have established that 5-fluorouracil-based adjuvant chemotherapy following resection of stage III colon cancer reduces subsequent mortality by as much as 30%. However, the extent to which adjuvant therapy is used outside the clinical trial setting, particularly among the elderly, is unknown. METHODS: A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results/Medicare-linked database identified 6262 patients aged 65 years and older with resected stage III colon cancer. The primary outcome was chemotherapy use within 3 months of surgery, as ascertained from Medicare claims. We examined the extent to which age at diagnosis was associated with adjuvant chemotherapy usage, and we adjusted for potential confounding based on differences in other patient characteristics with the use of multiple logistic regression. All P values were two-sided. RESULTS: Age at diagnosis was the strongest determinant of chemotherapy: 78% of patients aged 65-69 years, 74% of those aged 70-74 years, 58% of those aged 75-79 years, 34% of those aged 80-84 years, and 11% of those aged 85-89 years received postoperative chemotherapy. The age trend remained pronounced after adjustment for potential confounding based on variation in patients' demographic and clinical characteristics and after exclusion of patients with any evident comorbidity (all P values <.001). CONCLUSIONS: Adjuvant chemotherapy for stage III colon cancer is used extensively, especially for patients under the age of 75 years. However, treatment rates decline dramatically with chronologic age. Because patients in their 70s and even 80s have a reasonable life expectancy, further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding this potentially curative treatment.

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Metadata

Authors
Schrag, D., Cramer, L. D., Bach, P. B., & Begg, C. B.
Venue
JNCI Journal of the National Cancer Institute
Published
2001-06-06
Volume
93
Issue
11
Pages
850-857
ISSN
  • 0027-8874 (ISSN-L)
  • 1460-2105
OpenAlex
W2122136304
Cited by
481
References
39
FWCI
6.92
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Age and Adjuvant Chemotherapy Use After Surgery for Stage III Colon Cancer. https://app.cochat.ai/papers/10.1093/jnci/93.11.850
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Schrag, D., Cramer, L. D., Bach, P. B., & Begg, C. B. (2001). Age and Adjuvant Chemotherapy Use After Surgery for Stage III Colon Cancer. JNCI Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/93.11.850

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