Table 3.
Likelihood of oxaliplatin receipt in stage III colon cancer patients treated with adjuvant chemotherapy*
| Patient and clinical characteristics | Effectiveness: adjusted OR for oxaliplatin receipt within strata |
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| SEER–Medicare (1445/2458)† |
CanCORS (147/272)† |
NYSCR–Medicaid, <65 y (66/290)† |
NYSCR–Medicare, ≥65 y (228/446)† |
NCCN (561/594)† |
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| Ox, N (%) | Adjusted OR (95% CI) | Ox, N (%) | Adjusted OR (95% CI) | Ox, N (%) | Adjusted OR (95% CI) | Ox, N (%) | Adjusted OR (95% CI) | Ox, N (%) | Adjusted OR (95% CI) | |
| Age, y | ||||||||||
| <50 | 28 (60) | 1.04 (054 to 2.03) | 24 (65) | 2.79 (1.09 to 7.19) | 28 (27) | 1 (referent) | — | — | 167 (97) | 0.98 (0.18 to 5.22) |
| 50–64 | 154 (61) | 0.87 (0.64 to1.18) | 84 (61) | 2.09 (1.06 to 4.12) | 38 (21) | 0.64 (0.34 to 1.19) | — | — | 266 (95) | 0.65 (0.16 to 2.61) |
| 65–69 | 717 (63) | 1 (referent) | 22 (43) | 1 | — | — | 119 (54) | 1 (referent) | 77 (96) | 1 (referent) |
| 70–74 | 543 (53) | 0.67 (0.56 to 0.81) | 17 (37) | 0.92 (0.38 to 2.23) | — | — | 109 (48) | 0.76 (0.51 to 1.14) | 51 (82) | 0.09 (0.02 to 0.43) |
| Sex | ||||||||||
| Women | 753 (59) | 1 (referent) | 53 (55) | 1 (referent) | 35 (24) | 1 (referent) | 123 (51) | 1 (referent) | 293 (94) | 1 (referent) |
| Men | 692 (59) | 0.88 (0.74 to1.05) | 94 (54) | 1.14 (0.66 to1.96) | 31 (21) | 0.81 (0.43 to1.51) | 105 (51) | 0.93 (0.61 to 1.41) | 268 (95) | 1.30 (0.57 to 3.02) |
| Race‡ | ||||||||||
| White | 1220 (60) | 1 (referent) | 105 (55) | 1 (referent) | 38 (24) | 1 (referent) | 199 (54) | 1 (referent) | 432 (95) | 1 (referent) |
| Black | 129 (48) | 0.73 (0.55 to0.97) | 29 (62) | 1.12 (0.56 to 2.24) | 20 (21) | 1.05 (0.51 to2.11) | 21 (36) | 0.44 (0.23 to 0.83) | 63 (89) | 0.55 (0.19 to 1.55) |
| Asian | — | § | 0.27 (0.07 to 0.97) | § | 0.88 (0.31 to 2.33) | § | 0.36 (0.13 to 0.91) | — | — | |
| Other | 96 (59) | 0.88 (0.62 to1.24) | § | 0.51 (0.20 to 1.31) | 66 (99) | 6.77 (0.68 to 67.63) | ||||
| Latino | ||||||||||
| Yes | 93 (60) | 1.04 (0.73 to1.50) | NA | NA | 20 (27) | 1.15 (0.54 to2.37) | 13 (51) | 1.19 (0.48 to 3.02) | 34 (89) | 0.30 (0.08 to 1.10) |
| No | 1352 (59) | 1 (referent) | — | — | 46 (21) | 1 (referent) | 215 (51) | 1 (referent) | 486 (95) | 1 (referent) |
| Performance status/comorbidity‖ | ||||||||||
| 0/None | 1287 (62) | 1 (referent) | 55 (62) | 1 (referent) | 48 (24) | 1 (referent) | 178 (54) | 1 (referent) | 433 (97) | 1 (referent) |
| 1/Mild | 106 (43) | 0.75 (0.56 to1.02) | 58 (56) | 0.85 (0.45 to 1.58) | § | 1.37 (0.54 to 3.31) | 36 (54) | 1.02 (0.57 to 1.81) | 77 (89) | 0.37 (0.14 to 0.97) |
| ≥2/Moderate | 52 (35) | 0.54 (0.37 to0.79) | 22 (51) | 0.82 (0.37 to1.84) | § | 0.66 (0.18 to1.94) | 14 (33) | 0.51 (0.24 to 1.06) | 51 (85) | 0.22 (0.08 to 0.63) |
| Severe | — | — | 12 (33) | 0.35 (0.14 to 0.84) | — | — | — | — | — | — |
| Unknown | — | — | — | — | § | 1.47 (0.42 to 4.55) | — | — | — | — |
| Marital status | ||||||||||
| Married | 919 (62) | 1 (referent) | NA | NA | 26 (27) | 1 | 130 (51) | 1 (referent) | NA | NA |
| Single | 151 (55) | 0.74 (0.56 to 1.00) | — | — | 25 (21) | 0.57 (0.28 to1.15) | 27 (42) | 0.60 (0.32 to 1.12) | — | — |
| Widowed/divorced | 322 (53) | 0.68 (0.55 to 0.84) | — | — | 15 (24) | 0.98 (0.41 to 2.28) | 66 (54) | 1.12 (0.68 to 1.83) | — | — |
| Other | 53 (58) | 0.76 (0.48 to 1.21) | — | — | 0 (0) | 0.00 (− to 3.78) | § | 0.54 (0.13 to 2.13) | — | — |
| AJCC stage | ||||||||||
| IIIA | 177 (55) | 1 (referent) | 17 (49) | 1 (referent) | § (15) | 1 (referent) | 21 (39) | 1 (referent) | 66 (90) | 1 (referent) |
| IIIB | 748 (56) | 1.15 (0.89 to1.50) | 69 (51) | 1.17 (0.53 to 2.58) | 36 (21) | 1.62 (0.48 to 7.47) | 110 (48) | 1.16 (0.60 to 2.25) | 291 (95) | 1.18 (0.34 to 4.06) |
| IIIC | 518 (64) | 1.54 (1.16 to 2.05) | 53 (61) | 1.57 (0.67 to 3.71) | 27 (27) | 2.08 (0.59 to 9.93) | 94 (60) | 2.00 (1.01 to 4.01) | 201 (95) | 1.08 (0.29 to 4.06) |
| III NOS | — | § | 1.09 (0.26 to 4.50) | 0 (0) | — | — | ||||
| Differentiation | ||||||||||
| Well/Moderate | 996 (58) | 1 (referent) | 110 (55) | 1 (referent) | 44 (21) | 1 (referent) | 148 (51) | 1 (referent) | 392 (95) | 1 (referent) |
| Un/Poor | 407 (59) | 0.97 (0.79 to1.18) | 33 (49) | 0.79 (0.42 to1.47) | 21 (24) | 1.13 (0.58 to 2.16) | 69 (51) | 0.94 (0.60 to 1.47) | 148 (95) | 0.90 (0.35 to 2.30) |
| Unknown | 42 (63) | 1.15 (0.67 to 1.97) | § | 2.11 (0.30 to 4.98) | § | 0.47 (0.02 to 3.17) | § (57) | 1.27 (0.39 to 4.35) | 21 (81) | 0.11 (0.02 to 0.48) |
| Median Income¶ | ||||||||||
| >$65 000 | 227 (70) | 2.13 (1.59 to 2.86) | NA | NA | § (30) | 1.21 (0.37 to 3.64) | 52 (60) | 0.96 (0.51 to 1.81) | 144 (98) | 3.83 (0.87 to16.77) |
| $50 000–$65 000 | 262 (63) | 1.55 (1.20 to 1.99) | — | — | § | 0.44 (0.15 to1.11) | 42 (42) | 0.55 (0.30 to 1.00) | 132 (94) | 1.21 (0.40 to 3.62) |
| $35 000–$50 000 | 466 (61) | 1.35 (1.10 to 1.66) | — | — | 20 (24) | 0.88 (0.44 to1.75) | 70 (51) | 0.70 (0.40 to 1.22) | 149 (93) | 0.73 (0.27 to 2.01) |
| <$35 000 | 491 (52) | 1 (referent) | — | — | 33 (24) | 1 (referent) | 61 (54) | 1 (referent) | 136 (93) | 1 (referent) |
| Diagnosis year | ||||||||||
| 2004 | 255 (37) | 1 (referent) | 116 (53) | 1 (referent) | § | 1 (referent) | 64 (42) | 1 (referent) | — | — |
| 2005 | 372 (61) | 2.82 (2.23 to 3.55) | 31 (60) | 1.35 (0.70 to 2.63) | 26 (27) | 3.76 (1.68 to 9.01) | 85 (54) | 1.76 (1.10 to 2.84) | 66 (92) | 1 (referent) |
| 2006 | 404 (70) | 3.62 (2.81 to 4.66) | — | — | 30 (33) | 4.99 (2.22 to12.07) | 76 (63) | 2.55 (1.53 to 4.29) | 137 (96) | 1.86 (0.49 to7.01) |
| 2007 | 414 (71) | 3.87 (3.00 to 4.99) | — | — | — | — | — | — | 124 (93) | 0.99 (0.29 to 3.48) |
| 2008 | — | — | — | — | — | — | — | — | 150 (94) | 0.84 (0.24 to 2.90) |
| 2009 | — | — | — | — | — | — | — | — | 84 (97) | 1.78 (0.37 to 8.71) |
Percent of patients within each stratum treated with oxaliplatin and multivariable logistic regression of factors associated with receipt of oxaliplatin-containing compared with non–oxaliplatin-containing chemotherapy. ACE-27 = Adult Comorbidity Evaluation-27; AJCC = American Joint Committee on Cancer; CanCORS = Cancer Care Outcomes Research & Surveillance Consortium; CCI = Charlson Comorbidity Index; NCCN = National Comprehensive Cancer Network Outcomes Database; NYSCR–Medicaid = New York State Cancer Registry linked to Medicaid claims; NYSCR–Medicare = New York State Cancer Registry linked to Medicare claims; N = Node; NA = not available; OR = odds ratio; Ox = oxaliplatin; SEER–Medicare = Surveillance, Epidemiology, and End Results registry linked to Medicare claims; T = tumor.
Patients receiving oxaliplatin/total No. of patients.
Race: In SEER–Medicare, NYSCR–Medicaid, NYSCR–Medicare, and NCCN, Asian patients are included with “other” because of small numbers. In NCCN, the “unknown” patients are most likely non-Latinos, but they did not specifically state that.
N < 11. Value omitted to ensure patient confidentiality.
Comorbidity: CanCORS reports comorbidity using the ACE-27, NCCN, the CCI, NYSCR, the Deyo modification of the CCI, and SEER–Medicare, the Deyo-Klabunde modification of the CCI.
Income was measured categorically in CanCORS: >$60 000; $40 000–60 000; $20 000–40 000; <$20 000. Income is measured by census tract in SEER–Medicare and NYSCR cohorts. Because of missing values, income was not retained in the final model for CanCORS; however, when included in the full case, model estimates were not affected by inclusion of income.