Impact of duration of adjuvant therapy (AT) on cancer survival.
Bibliographic record
Abstract
6513 Background: Trials demonstrate that patients (pts) with specific cancers who complete AT experience better outcomes than those who do not. However, the magnitude of benefit in pts who discontinue AT early is poorly defined. Using a population-based cohort of stage III colon cancer (CC) pts, our aims were to (1) examine the rate of receiving all planned AT, (2) determine the factors associated with AT completion, and (3) explore the relationship between early AT discontinuation and survival. Methods: We analyzed pts diagnosed with stage III CC from 2006 to 2010 and initiated at least 1 cycle of adjuvant FOLFOX at any 1 of 5 regional cancer centers in British Columbia. Logistic regression models were constructed to determine the factors associated with AT completion, which was defined as receipt of >/= 10 cycles of FOLFOX. Kaplan-Meier methods and Cox regression that accounted for prognostic factors were used to evaluate the relationship between early AT discontinuation and disease-free (DFS) and overall survival (OS). Results: We identified 616 patients: median age 62 years (range 26-80), 52% men, 87% T3/4 tumors, and 40% N2 disease. Among them, 183 (30%) received < 10 and 433 (70%) underwent >/= 10 cycles. Adjusting for confounders, men and those with obstruction/perforation were more likely to discontinue AT early (OR for AT completion 0.62, 95%CI 0.43-0.89, p=0.01 and 0.55, 95%CI 0.33-0.92, p=0.02, respectively). In terms of survival, T3/4 stage, N2 disease and long post-operative recovery of >/= 1 week were correlated with worse DFS, while T4 stage and N2 disease were also associated with inferior OS. However, early discontinuation of AT did not impact DFS and OS (Table). Sensitivity analyses using different definitions for AT completion produced similar findings. Conclusions: Early discontinuation of adjuvant FOLFOX was not associated with significant survival differences, lending support to trials that are underway evaluating the utility of shorter durations of AT. DFS OS HR p HR p >/=10 cycles 1.0 .40 1.0 .76 <10 cycles 1.15 1.07 No obstruction/perforation 1.0 <.001 1.0 .13 Obstruction/perforation 1.95 1.47 T1/2 1.0 .02 1.0 .09 T3 2.31 <.001 2.19 .002 T4 3.72 4.44 N1 1.0 <.001 1.0 .002 N2 1.95 1.83 <7 days post-op stay 1.0 .049 1.0 .49 >/=7 days post-op stay 1.47 1.19
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 |
| 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".