AIM: To examine the extent of use of specific therapies in clinical practice, and their relationship to therapies validated in clinical trials. METHODS: The US National Cancer Institutes' Patterns of Care study was used to examine therapies and survival of patients diagnosed in 2001 with histologically-confirmed gastroesophageal adenocarcinoma (n = 1356). The study re-abstracted data and verified therapy with treating physicians for a population-based stratified random sample. RESULTS: Approximately 62% of patients had stomach adenocarcinoma (SAC), while 22% had gastric-cardia adenocarcinoma (GCA), and 16% lower esophageal adenocarcinoma (EAC). Stage IV/unstaged esophageal cancer patients were most likely and stage I-III stomach cancer patients least likely to receive chemotherapy as all or part of their therapy; gastric-cardia patients received chemotherapy at a rate between these two. In multivariable analysis by anatomic site, patients 70 years and older were significantly less likely than younger patients to receive chemotherapy alone or chemoradiation for all three anatomic sites. Among esophageal and stomach cancer patients, receipt of chemotherapy was associated with lower mortality; but no association was found among gastric-cardia patients. CONCLUSION: This study highlights the relatively low use of clinical trials-validated anti-cancer therapies in community practice. Use of chemotherapy-based treatment was associated with lower mortality, dependent on anatomic site. Findings suggest that physicians treat lower esophageal and SAC as two distinct entities, while gastric-cardia patients receive a mix of the treatment strategies employed for the two other sites.
AIM: To examine the extent of use of specific therapies in clinical practice, and their relationship to therapies validated in clinical trials. METHODS: The US National Cancer Institutes' Patterns of Care study was used to examine therapies and survival of patients diagnosed in 2001 with histologically-confirmed gastroesophageal adenocarcinoma (n = 1356). The study re-abstracted data and verified therapy with treating physicians for a population-based stratified random sample. RESULTS: Approximately 62% of patients had stomach adenocarcinoma (SAC), while 22% had gastric-cardia adenocarcinoma (GCA), and 16% lower esophageal adenocarcinoma (EAC). Stage IV/unstaged esophageal cancerpatients were most likely and stage I-III stomach cancerpatients least likely to receive chemotherapy as all or part of their therapy; gastric-cardiapatients received chemotherapy at a rate between these two. In multivariable analysis by anatomic site, patients 70 years and older were significantly less likely than younger patients to receive chemotherapy alone or chemoradiation for all three anatomic sites. Among esophageal and stomach cancerpatients, receipt of chemotherapy was associated with lower mortality; but no association was found among gastric-cardiapatients. CONCLUSION: This study highlights the relatively low use of clinical trials-validated anti-cancer therapies in community practice. Use of chemotherapy-based treatment was associated with lower mortality, dependent on anatomic site. Findings suggest that physicians treat lower esophageal and SAC as two distinct entities, while gastric-cardiapatients receive a mix of the treatment strategies employed for the two other sites.
Authors: Brenda K Edwards; Martin L Brown; Phyllis A Wingo; Holly L Howe; Elizabeth Ward; Lynn A G Ries; Deborah Schrag; Patricia M Jamison; Ahmedin Jemal; Xiao Cheng Wu; Carol Friedman; Linda Harlan; Joan Warren; Robert N Anderson; Linda W Pickle Journal: J Natl Cancer Inst Date: 2005-10-05 Impact factor: 13.506
Authors: Deirdre P Cronin; Linda C Harlan; Limin X Clegg; Jennifer L Stevens; Gigi Yuan; Thomas A Davis Journal: Hematol Oncol Date: 2005-06 Impact factor: 5.271
Authors: Deirdre P Cronin; Linda C Harlan; Arnold L Potosky; Limin X Clegg; Jennifer L Stevens; Margaret M Mooney Journal: Am J Gastroenterol Date: 2006-10 Impact factor: 10.864
Authors: Eric Van Cutsem; Vladimir M Moiseyenko; Sergei Tjulandin; Alejandro Majlis; Manuel Constenla; Corrado Boni; Adriano Rodrigues; Miguel Fodor; Yee Chao; Edouard Voznyi; Marie-Laure Risse; Jaffer A Ajani Journal: J Clin Oncol Date: 2006-11-01 Impact factor: 44.544
Authors: Katherine D Crew; Alfred I Neugut; Xiaoyan Wang; Judith S Jacobson; Victor R Grann; George Raptis; Dawn L Hershman Journal: J Clin Oncol Date: 2007-03-20 Impact factor: 44.544
Authors: David Cunningham; William H Allum; Sally P Stenning; Jeremy N Thompson; Cornelis J H Van de Velde; Marianne Nicolson; J Howard Scarffe; Fiona J Lofts; Stephen J Falk; Timothy J Iveson; David B Smith; Ruth E Langley; Monica Verma; Simon Weeden; Yu Jo Chua Journal: N Engl J Med Date: 2006-07-06 Impact factor: 91.245