% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Chen:170520,
      author       = {L.-J. Chen$^*$ and T. N. M. Nguyen$^*$ and J.
                      Chang-Claude$^*$ and M. Hoffmeister$^*$ and H. Brenner$^*$
                      and B. Schöttker$^*$},
      title        = {{A}ssociation of polypharmacy with colorectal cancer
                      survival among older patients.},
      journal      = {The oncologist},
      volume       = {26},
      number       = {12},
      issn         = {1549-490X},
      address      = {Hoboken, NJ},
      publisher    = {Wiley},
      reportid     = {DKFZ-2021-01979},
      pages        = {e2170-e2180},
      year         = {2021},
      note         = {#EA:C070#LA:C070# /2021 Dec;26(12):e2170-e2180},
      abstract     = {In geriatric oncology, polypharmacy is often assessed
                      during a comprehensive geriatric assessment. Previous
                      studies about its association with survival among colorectal
                      cancer (CRC) patients were inconclusive and had high risk
                      for indication bias.A cohort study was conducted with 3,239
                      CRC patients, aged ≥65 years, who were recruited in
                      Germany between 2003 and 2016 while being hospitalized for
                      CRC surgery. We defined polypharmacy as concurrent use of 5
                      or more drugs, and excessive polypharmacy (EPP) as
                      concurrent use of 8 or more drugs. Cox proportional hazards
                      regression models were performed to assess the associations
                      of polypharmacy with 5-year overall (OS), CRC specific
                      (CSS), and non-cancer specific survival (NCS) with rigorous
                      adjustment for morbidity to minimize indication bias (e.g.,
                      for cancer stage, functional status, and 13 common
                      diseases/conditions).The prevalence of polypharmacy was
                      $54.7\%$ and that of EPP was $24.2\%.$ During up to 5 years
                      of follow-up, 1,070 participants died among whom 615 died of
                      CRC and 296 died of other causes than cancer. EPP was
                      statistically significantly associated with poorer up to
                      5-year OS (hazard ratio (HR) $[95\%$ CI]: 1.23 [1.02-1.47])
                      and CSS (1.31 [1.03-1.68]). HR point estimate for NCS was
                      higher than 1 (1.22) but not statistically
                      significant.Polypharmacy was very common and EPP was a weak
                      risk factor for mortality in this large cohort of older CRC
                      patients. Clinical trials are needed to address the
                      causality of this relationship because older CRC patients
                      might benefit from de-prescribing drugs without an
                      indication.The results of our study support the hypothesis
                      that excessive polypharmacy, defined as use of 8 or more
                      concurrently used active substances, has a negative impact
                      on older colorectal cancer (CRC) patients' prognosis. Our
                      study suggests to oncologists that performing a medication
                      review for older CRC patients with 8 drugs or more is
                      indicated (especially when a broader comprehensive geriatric
                      assessment is being performed). Such a medication review
                      should not only focus on reducing the number of medications
                      (by de-prescribing drugs without an indication) but should
                      also check the appropriateness of indicated drugs for older
                      (cancer) patients.},
      keywords     = {Colorectal cancer (Other) / Comprehensive Geriatric
                      Assessment (CGA) (Other) / Geriatric Oncology (Other) /
                      Polypharmacy (Other) / Survival (Other)},
      cin          = {C070 / C020 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C020-20160331 /
                      I:(DE-He78)C120-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34476870},
      doi          = {10.1002/onco.13961},
      url          = {https://inrepo02.dkfz.de/record/170520},
}