Why adjuvant chemotherapy for stage III colon cancer was not given: reasons for non-recommendation by clinicians or patient refusal

Gilbar, Peter, Lee, Andrew and Pokharel, Khageshwor (2015) Why adjuvant chemotherapy for stage III colon cancer was not given: reasons for non-recommendation by clinicians or patient refusal. Journal of Oncology Pharmacy Practice, . doi:10.1177/1078155215623086


Author Gilbar, Peter
Lee, Andrew
Pokharel, Khageshwor
Title Why adjuvant chemotherapy for stage III colon cancer was not given: reasons for non-recommendation by clinicians or patient refusal
Journal name Journal of Oncology Pharmacy Practice   Check publisher's open access policy
ISSN 1078-1552
1477-092X
Publication date 2015
Sub-type Article (original research)
DOI 10.1177/1078155215623086
Open Access Status Not Open Access
Total pages 7
Place of publication London, United Kingdom
Publisher Sage Publications
Collection year 2016
Language eng
Formatted abstract
Aim: The aim of our study was to evaluate stage III colon cancer patients discussed at a multidisciplinary team meeting to identify reasons for clinicians not recommending adjuvant chemotherapy and reasons for patients declining recommended chemotherapy.

Methods: A retrospective, single institution Australian study was conducted on all surgically managed stage III colon cancer patients diagnosed at the regional cancer centre at Toowoomba Hospital between July 2010 and December 2014. Reasons why adjuvant chemotherapy was not recommended by the multidisciplinary team or following referral to a medical oncologist and patients’ reasons for refusing chemotherapy despite medical oncology recommendation were determined.

Results: One hundred and nine patients were suitable for evaluation. Overall, 72 (66.1%) received adjuvant chemotherapy. Chemotherapy was not recommended in 25 (23.4%) of patients, with the majority (68%) having more than one cited reason. Multiple comorbidities and advanced age were the most common reasons for non-recommendation (p < 0.01). Age alone was not a reason for not recommending chemotherapy. Twelve (11%) patients declined offered chemotherapy. The reasons for refusal were not detailed in the majority of patient charts (63.6%). Travel distance was not a factor in accepting or refusing chemotherapy.

Conclusion: Discussion at a multidisciplinary team meeting facilitates the identification of patients unsuitable for adjuvant treatment. The reasons for declining offered chemotherapy need to be assessed fully to ensure that patients’ treatment preferences are balanced against the proven benefits of chemotherapy. Attendance at a regional cancer centre provides the opportunity for high standard care in the management of stage III colon cancer.
Keyword Chemotherapy
Colon cancer
Age
Comorbidities
Multidisciplinary team
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: Google Scholar Search Google Scholar
Created: Mon, 21 Mar 2016, 10:54:55 EST by Jacky Cribb on behalf of Learning and Research Services (UQ Library)