Predictors of palliative treatment in stage IV colorectal cancer

Background: Palliative treatment may be associated with prolonged survival and improved quality of life, but remains underutilized in stage IV colorectal (CRC). We examined a national cohort of stage IV CRC patients to determine the factors associated with palliative treatment. Methods: Stage IV CRC patients, classified based on their survival length (<6 months, 6–24 months, and 24 + months), were analyzed using the American College of Surgeons National Cancer Data Base (2004–2013). Multivariable analysis was performed to evaluate factors associated with palliative treatment. Results: Of 85,981 patients analyzed, 10.9% received palliative treatment. For 6–24 months survival, a more recent year of diagnosis, Medicaid, uninsured status, Mountain and Pacific regions were associated with higher odds of palliative treatment. For those who survived < 6months, older patients had lower odds, while academic centers and residence > 20 miles from treating institutions were associated with increased likelihood of palliative treatment. Conclusions: Palliative treatment in stage IV CRC is associated with a more recent year of diagnosis, Medicaid, academic centers, Mountain and Pacific regions of the US.