Impact of delay in adjuvant oxaliplatin-based chemotherapy for stage III colon cancer.
Bibliographic record
Abstract
3561 Background: Less than 8 weeks (w) has been recommended as the optimal time to initiate adjuvant chemotherapy (AC) based upon two meta-analyses suggesting worse OS with delayed AC. However, neither included studies with oxaliplatin-based chemotherapy and the impact of its delay remains uncertain. Methods: Records of pts who initiated AC with either 5-FU or capecitabine plus oxaliplatin for stage III colon cancer between 2006 and 2011 at the BC Cancer Agency were reviewed. Cox proportional hazards models were used to analyze the impact of timing of AC on RFS. Pts were categorized into initiation of AC within 8 w (G1) and after 8 w (G2) Results: 635 pts (52% male) with a median age of 62 yrs (range 26–80) were included. Median lymph nodes examined and involved were 15 and 3, respectively. Median time from surgery to initiation of AC was 8.3 w (SD 18.58). At a median follow-up of 57.9 months, 176 pts (27.7%) have recurred and 118 (18.6%) have died. 5y-RFS was 70.9% (95% CI 65.2-76.5) for G1 and 72.1% (95%CI 67.2-77) for G2. On multivariate analysis, T stage, N stage, obstruction and perforation were identified as poor prognostic factors for RFS. Timing for AC did not have prognostic significance (HR 1.03, p = 0.83). Conclusions: In our population-based study, time to oxaliplatin-based AC following stage III colon resection did not impact on RFS. Contrary to most of the existing data which is primarily based on 5FU-based AC, delay of oxaliplatin-based therapy beyond 8 w is not associated with inferior outcomes. Prognostic factors for RFS – univariate and multivariate analysis. Variables Univariate HR p value Multivariate HR p value Age <65 ≥65 1.0 0.49 1.0 0.55 1.11 1.09 Male Female 1.0 0.19 1.0 0.22 1.21 1.20 Grade 1/2 3 1.0 0.04 1.0 0.72 1.44 1.06 LVI no yes 1.0 < 0.001 1.0 0.05 1.89 3.12 PNI no yes 1.0 0.005 1.0 0.84 1.69 1.04 T 1/2 T3 T4 1.0 < 0.001 1.0 0.003 2.69 2.16 5.42 3.27 N1 N2 1.0 < 0.001 1.0 <0.001 2.11 1.80 Examined LN ≤12 >12 1.0 0.85 1.0 0.05 0.97 0.72 Obstruction no yes 1.0 < 0.001 1.0 0.007 2.18 1.73 Perforation no yes 1.0 < 0.001 1.0 0.002 3.40 2.45 Location right left 1.0 0.02 1.0 0.07 1.40 1.32 Time surgery-chemo ≤ 8 w > 8 w 1.0 0.60 1.0 0.83 1.08 1.03
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".