Refusal of postoperative radiotherapy and its association with survival in XXXX .

@entity1 @entity135 @entity5
BACKGROUND AND PURPOSE: Administering postoperative radiotherapy (PORT) is associated with improved survival and slower disease progression in select @entity135 @entity1 . Predictive factors for PORT refusal have not been described in this population. MATERIALS AND METHODS: Retrospective analysis of 6127 @entity135 @entity1 who received or refused PORT in the National @entity5 Database (2003-2006) was performed. Statistical analysis included Chi-square, multivariable logistic regression, Kaplan-Meier, and Cox proportional hazards analysis. RESULTS: In total, 247 @entity1 (4.0%) refused PORT. Three-year overall survival was 62.8% versus 53.4% for those who received and refused PORT, respectively. PORT refusers were more likely to have negative nodes than those who underwent PORT (37.4% versus 20.1%, p<.001). In multivariate analysis, predictive factors for refusing PORT included living far from the treatment facility (OR 1.92), having negative nodes (OR 2.14), and Charlson score of    2 (OR 2.14) (all p   .001). PORT refusal was associated with increased mortality (hazard ratio 1.20, p=.044). CONCLUSIONS: A significant proportion of @entity135 @entity1 refused PORT; this was associated with compromised overall survival. Predictive factors for PORT refusal included socioeconomic, demographic, and pathologic variables. Elucidating root causes of refusal may lead to interventions that improve long-term outcomes.
