Background: Variations in treatment choices have been reported in colorectal cancer (CRC). In the context of national recommendations, we aimed to elucidate predictors and between-hospital variations in refraining from curatively intended surgery and adjuvant chemotherapy in potentially curable colorectal cancer. Methods: A total of 34,116 patients diagnosed with CRC from 2009 to 2018 were included for analyses on non-curative treatment in this register-based study. Subsequently 8006 patients were included in analyses on adjuvant treatment. Possible predictors included patient-, disease-, socioeconomic- and perioperative-related factors. Logistic regressions were utilized to examine the predictors of a non-curative aim of treatment and no adjuvant chemotherapy. Results: The predictors of non-curative treatment were high age, poor performance, distant metastases and being underweight. Predictors for no adjuvant treatment were high age, poor performance, kidney disease, postoperative complications and living alone. For both outcomes we found between-hospital variations to be present. Conclusions: Non-curative overall treatment and refraining from adjuvant chemotherapy were associated with well-known risk factors, but the former was also associated with being underweight and the latter was also associated with living alone. Marked between-hospital variations were found and should be examined further.
背景：结直肠癌（CRC）的治疗选择存在差异。在国家诊疗指南的框架下，本研究旨在阐明在具有潜在治愈可能的结直肠癌患者中，放弃根治性手术及辅助化疗的预测因素及医院间差异。方法：这项基于登记数据的研究共纳入2009年至2018年诊断为结直肠癌的34,116例患者，用于分析非根治性治疗情况；随后纳入其中8006例患者进行辅助治疗分析。可能的预测因素包括患者相关、疾病相关、社会经济相关及围手术期相关因素。采用逻辑回归分析检验非根治性治疗目标及未接受辅助化疗的预测因素。结果：非根治性治疗的预测因素包括高龄、体能状态差、远处转移及体重过轻。未接受辅助治疗的预测因素包括高龄、体能状态差、肾脏疾病、术后并发症及独居生活。两种结局均存在显著的医院间差异。结论：非根治性整体治疗及放弃辅助化疗与已知风险因素相关，但前者还与体重过轻相关，后者则与独居生活相关。研究观察到显著的医院间差异，需进一步深入探讨。
肿瘤(癌症)患者之家