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• W2017184051 abstract "The presence of co-morbidities may result in selection bias in cancer management because of the concern that patients will not tolerate definitive therapy. Hence, the specific aim of this ACR QRRO-based retrospective survey was to determine the impact of patient co-morbid illness on national patterns of practice in patients treated for Stage IB-IV (non-metastatic) gastric cancer. A National Process Survey using retrospective on-site record review was conducted for patients treated from 2005 to 2007. A stratified random sample of 106 U.S. radiation (RT) facilities was invited. The goal was to examine the affect of patient co-morbidities using the Adult Co-morbidity Evaluation Index (ACE-27) on practice patterns among non-metastatic gastric cancer cases that received RT as a component of their multi-disciplinary care and had a Karnofsky performance status (KPS) > 60. Practice patterns assessed included: receipt of planned RT, surgery and chemotherapy; type of resection; completion of primary tumor resection or lymph node resection; reduction of RT fields; need for parenteral or enteral nutritional support, and the ability to administer concurrent chemotherapy. Co-morbidities were graded as mild, moderate or severe per the Piccirillo Index. Pearson's chi-square was used to test for associations between co-morbidities and practice patterns. Data were collected through August, 2010 for 250 eligible patients from 45 participating institutions. Median age was 63 years; 65% male; 11% KPS > 60 to < 80, 89% KPS > 80 to 100; 68% Caucasian. Overall, 14% were AJCC 2002 Stage I, 27% II, 30% IIIA, 9% IIIB and 14% IV disease. Co-morbidity was present in 68% of patients (mild 43%, moderate 15% and severe 10%). The presence of co-morbidity was associated with the following: performing less than a total gastrectomy P = 0.055, less than a complete primary resection P = 0.044, and laparoscopic resection P = 0.058, as well as significantly influencing a change in the planned multi-disciplinary treatment P<0.00001. The presence of patient co-morbidities appeared to influence treatment delivery in Stage IB-IV (non-metastatic) gastric cancers receiving adjuvant RT. Therefore, incorporation of co-morbidity assessment in future prospective gastric cancer studies is warranted to determine whether pretreatment co-morbid illness is associated with non-compliance with protocol treatment guidelines and, potentially, diminished treatment effectiveness." @default.
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• W2017184051 date "2011-10-01" @default.
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• W2017184051 title "Impact of Co-morbidities on Practice Patterns in the Management of Gastric Cancer: Findings from the Quality Research in Radiation Oncology (QRRO) GI Committee Process Survey" @default.
• W2017184051 doi "https://doi.org/10.1016/j.ijrobp.2011.06.880" @default.
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