Although to varying degrees across age groups, using multiagent chemotherapy in GIST stromal tumors has improved overall survival (OS). This extensive database study intends to evaluate the variations in chemotherapy use in GIST Stromal tumors in the clinical context.
Material and Methods
Patients having GIST stromal tumor diagnoses from 2010 to 2020 were located using the National Cancer database. Using the χ2 test, baseline characteristics were compared between those that underwent chemotherapy and those that did not. The link between various sociodemographic characteristics with the receipt of chemotherapy in the overall cohort and across different age groups was assessed using Binary logistic regression.
Out of 16,238 patients, 6.5% (1061 patients) did not receive chemotherapy. Patients aged <65 years were more likely to receive chemotherapy compared to those aged >65 years (Adjusted Odds ratio [AOR]=1.662, 95% confidence interval [CI]=1.35-2.044, p<0.001). Males had higher chances of receiving chemotherapy than females (AOR=1.173, 95% CI=1.02-1.34, p=0.02). Patients visiting academic centers were more likely to receive chemotherapy than nonacademic centers (AOR=1.340, 95% CI=1.15-1.55, p=0.002). Patients with lower Charlson-Deyo scores (CDS) were more likely to receive chemotherapy: CDS 2 (AOR=0.49, 95% CI=0.39-0.62, p<0.001), CDS 1 (AOR=0.21, 95% CI=0.17-0.27, p<0.001), and CDS 0 (AOR=0.04, 95% CI=0.03-0.05, p<0.001) when compared to CDS 3..Regarding income status , there were non-significant decrease in number of patients receiving chemotherapy when having income status <=$74,063. Similarly, government insurance, including Medicaid and Medicare, private insurance and other government insurance have not been associated with significantly increased likelihood of receiving chemotherapy.
In the US, a sizable minority of people over 65 do not receive chemotherapy. Patients over 65 years, males, and those visiting academic centers were more likely to receive chemotherapy, while patients with lower Charlson- Deyo scores were less likely to receive it. Insurance status and income status were not associated significantly with likelihood of receiving chemotherapy