TABLE 3.
Multivariable logistic regression predictors of adherence to CoC Quality Measure 2b (referral for adjuvant chemotherapy with 180 days of resection for patients with pN1 or pN2 disease at the time of surgery) and influence on all-cause mortality as predicted by Cox proportional hazards modeling
| Adjuvant chemotherapy within 180 days of surgery n = 109,625 |
|||||
|---|---|---|---|---|---|
| Sample percentage | Failure percentage | Failure proportion P value | Odds ratio for failure (95% CI) | Hazard ratio for failure (95% CI) | |
| Sex | <.001 | ||||
| Male | 55.45 | 68.25 | 1.10 (1.07–1.141 | 1.19 (1.18–1.22) | |
| Female | 44.55 | 64.32 | Reference | Reference | |
| Age, y | <.001 | ||||
| <40 | 0.54 | 54.53 | 0.68 (0.57–0.81) | 0.86 (0.78–0.97) | |
| 40–49 | 4.96 | 55.54 | 0.85 (0.80–0.91) | 0.92 (0.88–0.97) | |
| 50–59 | 16.91 | 57.86 | Reference | Reference | |
| 60–69 | 32.03 | 62.62 | 1.34 (1.29–1.39) | 1.20 (1.17–1.23) | |
| 70–79 | 34.87 | 72.81 | 2.30 (2.20–2.40) | 1.52 (1.48–1.56) | |
| ≥80 | 10.68 | 87.73 | 7.09 (6.55–7.68) | 1.99 (1.92–2.07) | |
| Race and ethnicity | .003 | ||||
| Non-Hispanic white | 85.94 | 66.47 | Reference | Reference | |
| Non-Hispanic black | 8.72 | 66.32 | 1.06 (0.99–1.14) | 1.00 (0.96–1.03) | |
| Hispanic | 2.26 | 67.35 | 1.06 (0.94–1.18): | 0.97 (0.91–1.03) | |
| Asian | 1.75 | 64.66 | 1.06 (0.91–1.24) | 0.80 (0.76–0.85) | |
| Other/unknown | 1.33 | 70.87 | 1.34 (1.17–1.53) | 0.93 (0.86–1.02) | |
| Zip Code income quartile | <.001 | ||||
| Lowest quartile | 14.90 | 70.29 | 1.09 (0.97–1.22) | 1.06 (1.01–1.10) | |
| Second quartile | 19.24 | 67.81 | 1.03 (0.94–1.13) | 1.02 (0.98–1.05) | |
| Third quartile | 27.08 | 66.30 | 1.02 (0.95–1.09) | 1.04 (1.02–1.07) | |
| Fourth quartile | 34.00 | 64.74 | Reference | Reference | |
| Other/unknown | 4.78 | 64.17 | 0.72 (0.16–3.34) | 0.94 (0.37–2.76) | |
| Zip Code education quartile | <.001 | ||||
| Lowest quartile | 17.67 | 70.19 | 1.28 (1.16–1.41) | 1.08 (1.04–1.12) | |
| Second quartile | 24.21 | 67.54 | 1.15 (1.07–1.23) | 1.07 (1.04–1.11) | |
| Third quartile | 23.04 | 65.54 | 1.05 (1.00–1.10) | 1.04 (1.01–1.07) | |
| Fourth quartile | 30.29 | 64.80 | Reference | Reference | |
| Other/unknown | 4.79 | 64.19 | 1.47 (0.32–6.77) | 1.10 (0.32–3.23) | |
| Insurance status | .52 | ||||
| Medicaid or uninsured | 93.29 | 66.52 | 1.37 (1.27–1.48) | 1.13 (1.09–1.18) | |
| Other insurance | 6.71 | 66.16 | Reference | Reference | |
| Clinical stage | <.001 | ||||
| 0 | 0.03 | 70.37 | 0.84 (0.39–1.79) | 1.35 (0.71–2.54) | |
| I | 0.69 | 67.20 | Reference | Reference | |
| II | 40.71 | 66.02 | 0.76 (0.65–0.88) | 0.95 (0.84–1.07) | |
| III | 51.53 | 64.86 | 0.70 (0.60–0.82) | 1.48 (1.31–1.67) | |
| IV | 4.92 | 88.64 | 4.35 (3.56–5.32) | 3.25 (2.80–3.76) | |
| Other/unknown | 2.12 | 79.84 | 1.33 (1.08–1.65) | 1.49 (1.30–1.70) | |
| Tumor size, cm | <.001 | ||||
| ≤1 | 10.89 | 87.84 | Reference | Reference | |
| 2 | 2.16 | 62.44 | 0.90 (0.81–0.99) | 1.00 (0.94–1.06) | |
| 3 | 13.50 | 60.32 | 0.96 (0.87–1.06) | 1.06 (1.00–1.12) | |
| 5 | 20.50 | 63.61 | 1.01 (0.92–1.11) | 1.17 (1.09–1.24) | |
| 7 | 30.51 | 65.54 | 1.09 (0.98–1.21) | 1.32 (1.24–1.42) | |
| >8 | 13.60 | 67.05 | 1.16 (1.04–1.29) | 1.50 (1.40–1.61) | |
| Other/unknown | 8.83 | 67.61 | 3.55 (3.09–4.08) | 1.69 (1.57–1.82) | |
| Hospital location | <.001 | ||||
| Large urban region | 45.60 | 66.18 | Reference | Reference | |
| Medium urban region | 18.92 | 66.11 | 1.00 (0.91–1.11) | 1.06 (1.02–1.09) | |
| Small urban region | 27.57 | 67.53 | 1.04 (0.95–1.14) | 1.04 (1.01–1.08) | |
| Rural region | 2.45 | 69.04 | 1.07 (0.92–1.24) | 1.03 (0.96–1.11) | |
| Other/unknown | 5.47 | 64.39 | 1.00 (0.89–1.11) | 1.01 (0.95–1.08) | |
| Type of hospital | .01 | ||||
| Community | 65.48 | 66.24 | Reference | Reference | |
| Academic | 34.52 | 67.00 | 1.10 (0.96–1.27) | 0.90 (0.86–0.94) | |
| Travel distance, miles | .04 | ||||
| >5 | 29.25 | 66.96 | 1.07 (1.01–1.12) | 0.96 (0.94–0.98) | |
| <5 | 70.75 | 66.31 | Reference | Reference | |
| Time period* | <.001 | ||||
| 1998–2000 | 24.96 | 81.06 | Reference | Reference | |
| 2001–2003 | 23.90 | 77.21 | 0.76 (0.72–0.81) | 0.96 (0.93–0.99) | |
| 2004–2006 | 20.77 | 61.10 | 0.32 (0.30–0.35) | 0.95 (0.93–0.97) | |
| 2007–2009 | 19.29 | 57.37 | 0.27 (0.25–0.29) | Omitted* | |
| 2010–2011 | 11.08 | 52.73 | 0.20 (0.18–0.22) | Omitted* | |
| Adjuvant chemotherapy within 180 days of surgery | 1.41 (1.37–1.44) | ||||
CI, Confidence interval.
*
NCDB survival data only available for patients diagnosed from 1998–2006. Survival analysis n = 58,479.