MTP6.09 The impact of socioeconomic deprivation and receipt of chemotherapy on survival following elective surgery for TNM III colon cancer

Aims Trials for TNM stage II-III elective curative colon cancer optimising fitness are planned, however there is evidence to suggest deprived patients are disadvantaged in terms of receiving adjuvant chemotherapy (ACT) and consequently adverse survival. Therefore, this study compared socioeconomic deprivation (SED) and clinicopathological factors with receipt of ACT and overall survival in TNM stage III colon cancer. Methods TNM stage III patients undergoing elective curative surgery for colon cancer in the West of Scotland were identified from 2011-2014. The Scottish Index of Multiple Deprivation (SIMD) was divided into quintiles for interpretation. Receipt of ACT was defined as receiving any chemotherapy post-operatively. Results 790 patients with elective curative TNM stage III cancer were identified, 496 of whom (63%) received ACT. On MVA, increasing age (OR=0.24, p<0.001), deprivation (OR=0.85, p=0.033) and ASA (OR=0.42, p<0.001) were associated with lower likelihood of receiving ACT. On MVA, in patients who received ACT; current smoking (OR=1.60, p=0.009), higher ASA (OR=2.25, p<0.001) and higher BMI (OR=1.45, p=0.012) were associated with deprivation. On MVA, lower receipt of ACT (HR 0.48, p<0.001) and higher ASA (HR 1.34, p=0.008) but not deprivation (p=0.2366) were associated with poorer overall survival (OS). Conclusion In patients with TNM stage III colon cancer, deprivation impacts on poorer outcomes through greater comorbidity and less receipt of chemotherapy. Further work is required to improve the provision of adjuvant chemotherapy in the deprived and comorbid.