Influence of not having children on mortality in patients with metastatic (mCRC) colorectal cancer
Bibliographic record
Abstract
Background: Although there is evidence that parents live longer than non-parents, prognostic effect of parenthood in cancer patients is not well established. We previously noted that palliative use of chemotherapy in patients with mCRC significantly varied in those with and without children and use of chemotherapy was 3-fold lower in patients with no children (2018 GI Cancers Symposium). In this study we examined if childless individual with mCRC have higher mortality than patients with children. Methods: Patients with mCRC diagnosed in 2006-2010 in Saskatchewan were assessed. Cox proportional hazard multivariate analyses were performed to determine correlation between not having children and mortality. Results: 569 patients with median age 69 yrs (IQR 59-77) and M:F was 59:41 were identified. Of 569 patients, 461 (81%) had children. Significant differences were noted between the group with children and the group with no children with respect to being married/partnered (74 vs. 32%, p < 0.001), performance status ≥2 (33 vs. 45%, p = 0.02), distance to travel to cancer center > 100 km (45 vs. 60%, p = 0.007), low albumin (70 vs. 85%, p = 0.001), anemia (68 vs. 87%, p < 0.001), and use of chemotherapy (64 vs. 31, p < 0.001 respectively. On Cox proportional multivariate analysis after adjustment for other variables, not having children (HR 1.4; 95%CI: 1.10-1.90), not having chemotherapy (3.6, 2.8-4.6), no metastasectomy (2.15, 1.60-2.91), intact primary tumor (1.91, 1.56-2.33), leukocytosis (1.35, 1.07-1.70), elevated alkaline phosphatase (1.32, 1.07-1.62), performance status ≥2 (1.30, 1.10-1.60), right colon cancer (1.28, 1.04-1.57), grade III cancer (1.28, 1.05-1.56) and stage IVb disease (1.25, 1.04-1.50) were correlated with poor survival. Conclusions: The present study demonstrated that not having children was independently associated with an increased risk of mortality in patients with metastatic colorectal cancer. Future studies are warranted to confirm the finding and to determine underlying etiology. Legal entity responsible for the study: Shahid Ahmed. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.002 | 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".