Adherence to NCCN Guidelines Improves Colon Cancer Survival

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(ChemotherapyAdvisor) – Adherence to NCCN guidelines for the treatment of patients with high-risk stage II/III colon cancer is associated with improved survival outcomes, according to a study reported at the ASCO 2012 Gastrointestinal Cancers Symposium.

Genevieve Marie Boland, MD, PhD, of the University of Texas M.D. Anderson Cancer Center, Houston, TX, and colleagues noted that significant variability exists in the National Cancer Database with respect to the treatment of high-risk stage II/III colon cancer; therefore, they examined whether adherence to guidelines is associated with improved outcomes.

A total of 77,350 patients with colon adenocarcinoma from 1998–2002 were identified in the database. Stage-specific NCCN guidelines were used to classify patients into an adherent or a nonadherent group. Nonadherence as a result of chemotherapy omission was noted in 64.3% of high-risk stage II and 26.4% of high-risk stage III patients. Decreased overall survival and relative survival were observed in the nonadherent group; hazard risk for death was 1.43 for high-risk stage II and 1.89 for stage III (P<0.001). Differences in relative survival were found with gender, age, race, insurance, income, and type of facility.

The authors suggest “deviations from guidelines can be used to focus improvements in the access to and delivery of cancer treatment,” and also as an institutional performance metric.

This presentation was a 2012 Gastrointestinal Cancers Symposium Merit Award Winner.


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