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18.12.2017 | Original paper | Ausgabe 2/2018

Cancer Causes & Control 2/2018

Delivery of adjuvant chemotherapy among stage III colon cancer patients at a public versus private hospital in New York City

Zeitschrift:
Cancer Causes & Control > Ausgabe 2/2018
Autoren:
Daniel Lin, Judith D. Goldberg, Tsivia Hochman, Benjamin A. Levinson, Maria Khan, Elliot Newman, Lawrence P. Leichman, Heather T. Gold

Abstract

Purpose

Prior studies of timeliness of adjuvant chemotherapy (AC) initiation in stage III colon cancer have suggested longer time to AC at public compared with private hospitals. Few studies have explored differences in AC completion. We investigated whether timely initiation and completion of AC differed between a public and private hospital, affiliated with the same academic institution in a large, urban setting.

Methods

We conducted a retrospective cohort study of stage III colon cancer patients who had surgery and AC at the same medical center between 2008 and 2015, either at its affiliated public hospital (n = 43) or private hospital (n = 79). We defined timely initiation as receiving AC within 60 days postoperatively, and completion as receiving ≥ 75% of planned AC. Univariate and stepwise multivariable logistic regressions were used to identify factors associated with AC delivery.

Results

Median number of days to AC was significantly greater among patients at the public (53, range 31–231) compared with the private hospital (43, range 25–105; p = 0.002). However, the percentage of patients with timely AC initiation did not differ substantially by hospital (74 vs 81%, p = 0.40). In multivariable analysis, age (OR 0.95/year, 95% CI 0.91–0.99) and laparoscopic versus open surgery (OR 5.65, 95% CI 1.92–16.62) were significant factors associated with timely AC initiation. Moreover, AC completion did not differ significantly between public (83.7%) and private (89.9%) hospital patients (p = 0.32).

Conclusions

The proportions of patients with timely initiation and completion of AC were similar at a public and private hospital affiliated with a large, urban medical center. Future research should investigate how specific system-level factors help alleviate this expected difference in timely care delivery.

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Zusatzmaterial
Supplementary material 1 (DOCX 103 KB)
10552_2017_996_MOESM1_ESM.docx
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