Catherine Fitzgerald

University of British Columbia - Vancouver, Vancouver, British Columbia, Canada

Are you Catherine Fitzgerald?

Claim your profile

Publications (7)47.5 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND:: Stage for stage, rectal cancer has historically been associated with inferior survival compared with colon cancer. Randomized trials of rectal cancer have generally demonstrated improvements in locoregional relapse but not survival. OBJECTIVE:: We compared therapy and outcomes of colon versus rectal cancer in 2 time cohorts to determine if relative improvements have occurred. PATIENTS AND METHODS:: Patients with resected stage II/III colorectal cancer referred to the British Columbia Cancer Agency in 1989/1990 and 2001/2002 were identified. The higher of clinical or pathologic stage was used for patients receiving preoperative chemoradiation. Disease-specific survival (DSS) and overall survival (OS) were compared for rectal and colon cancer between the 2 cohorts. Kaplan-Meier method was used for survival analysis. RESULTS:: A total of 1427 patients were included, with 375 from 1989/1990 and 1052 from 2001/2002. Between 1989/1990 and 2001/2002 there were significant increases in the use of perioperative chemotherapy for both rectal and colon cancer (P<0.001) and use of preoperative radiation therapy (P<0.001) and total mesorectal excision (P<0.001) in rectal cancer. DSS significantly improved for rectal (P<0.001) but not colon cancer (P=0.069). Five-year OS was significantly inferior for rectal versus colon cancer in 1989/1990 (46.1% vs. 57.2%, P=0.023) and was similar to that of colon cancer in 2001/2002 (63.7% vs. 66.2%, P=0.454). CONCLUSIONS:: Advances in locoregional and systemic therapy significantly improved survival among patients with rectal cancer. DSS and OS are now similar between colon and rectal cancer for both stage II and III disease.
    No preview · Article · Aug 2012 · American journal of clinical oncology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: In the past 10 years, the number of available therapeutic options for patients with metastatic colorectal cancer (MCRC) has expanded from fluorouracil (FU) -based therapy to include irinotecan and oxaliplatin. The temporal impact of these advances on the overall survival of a population-based cohort will be evaluated. Patients and Methods: Cohort A from years 1995 to 1996 was chosen to represent FU-based chemotherapy. In 2000 and in 2003 to 2004, irinotecan and oxaliplatin respectively became generally available to patients in British Columbia, Canada; cohorts B and C were chosen from these years, respectively. Included were 1,333 patients referred with MCRC (metastatic status, M1) in cohorts A (n = 357), B (n = 268), and C (n = 708). Survival was calculated from time of diagnosis of M1 disease to either death or date of last contact. Results: Cohorts were generally similar; more patients received chemotherapy in cohorts B (62%) and C (62%) compared with cohort A (49%; P < .001). In cohort C, 33% of patients received both irinotecan and oxaliplatin, and 10% of patients received biologic therapies. In cohorts A, B, and C, median overall survival was 9.4, 10.8, and 13.1 months (A v C, P = .002; B v C, P = .022) in all patients, respectively, and 12.6, 14.0, and 17.1 months (A v C, P = .004; B v C; P = .019) in patients treated with chemotherapy, respectively. Improvements between cohorts A and C achieved statistical significance, whereas those between A and B did not. Patients not treated with chemotherapy experienced poor outcomes; this remained unchanged. Conclusion: In this population-based study, a significant prolongation in overall survival was observed in patients with MCRC in the period in which both irinotecan and oxaliplatin were available. Outcomes parallelled those seen in phase III clinical trials.
    Full-text · Article · Jul 2009 · Journal of Oncology Practice
  • Source
    Kenneth S Wilson · Catherine A Fitzgerald · Jeff B Barnett · Sharlene Gill · Kong E Khoo
    [Show abstract] [Hide abstract]
    ABSTRACT: Severe 5-FU toxicity in adjuvant therapy of colorectal cancer may require change of therapy. We retrospectively explored the safety and efficacy of adjuvant raltitrexed in patients intolerant of 5-FU. Over a 5 year period, patients who received 5-FU and subsequent raltitrexed therapy were identified. There were 44 patients, (39 stage III). Median number of prior 5-FU cycles was 2. Three year relapse free and overall survival proportions for stage III patients were 70.8% and 83.6%, respectively. Raltitrexed adjuvant therapy can be given safely and effectively in patients where further 5-FU is contraindicated.
    Full-text · Article · Jan 2008 · Cancer Investigation
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BCL-2 protein expression correlates with shorter survival in patients with diffuse large B cell lymphoma (DLBCL) who are treated with CHOP chemotherapy. We report a retrospective analysis of the prognostic significance of BCL-2 status in patients who received CHOP with the addition of rituximab (CHOP-R) for DLBCL. Patients over 15 years of age with de novo, HIV negative DLBCL, without CNS involvement, and known BCL-2 protein status were identified from the BCCA Lymphoid Cancer Database. BCL-2 tumour positivity was defined as over 50% of tumour cells with BCL-2 protein expression. 140 patients who received CHOP-R were analysed. The majority (59%) of patients were over 60 years of age. Disease stage distribution was limited (22%) and advanced (78%). BCL-2 protein expression was observed in 90 (64%) cases. IPI score was similar in both BCL-2 positive and negative cases. Median follow-up time for living patients is 40 months. BCL-2 status did not predict for either progression-free or overall survival. IPI score was predictive for progression-free survival but not overall survival. The addition of rituximab to CHOP chemotherapy negates the adverse prognostic influence of BCL-2 protein expression on progression free and overall survival in DLBCL.
    Full-text · Article · Jul 2007 · Leukemia and Lymphoma
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The increasing usage of rituximab in the management of non-Hodgkin lymphoma (NHL) has created huge logistical challenges with respect to the delivery of this time- and labor-intensive drug. To address these challenges, we developed and tested the feasibility of a 90-minute infusion schedule for rituximab (20% of the dose administered in the first 30 minutes, remaining 80% administered over 60 minutes). A safety analysis performed in 150 patients receiving rituximab with corticosteroid-containing chemotherapy and 56 patients receiving rituximab as maintenance therapy demonstrated that this schedule was well tolerated, with no grade 3 or 4 infusion reactions observed. In addition, no increase in minor reactions was noted. More than 1200 patients have been treated with this rapid rituximab infusion schedule in the province of British Columbia (BC), demonstrating its safety in the community setting. The adoption of this 90-minute schedule as standard practice has had a positive impact on resource utilization.
    Preview · Article · Jun 2007 · Blood
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity, with patients exhibiting a wide range of outcomes. The addition of rituximab to CHOP chemotherapy (R-CHOP)has led to a marked improvement in survival and has called into question the significance of previously recognized prognostic markers. Since randomized controlled trials of R-CHOP in DLBCL have included select subgroups of patients, the utility of the International Prognostic Index (IPI) has not been reassessed. We performed a retrospective analysis of patients with DLBCL treated with R-CHOP in the province of British Columbia to assess the value of the IPI in the era of immunochemotherapy. The IPI remains predictive, but it identifies only 2 risk groups. Redistribution of the IPI factors into a revised IPI (R-IPI) provides a more clinically useful prediction of outcome. The R-IPI identifies 3 distinct prognostic groups with a very good (4-year progression-free survival [PFS] 94%, overall survival [OS] 94%), good (4-year PFS 80%, OS 79%), and poor (4-year PFS 53%, OS 55%) outcome, respectively (P < .001). The IPI (or R-IPI) no longer identifies a risk group with less than a 50% chance of survival. In the era of R-CHOP treatment, the R-IPI is a clinically useful prognostic index that may help guide treatment planning and interpretation of clinical trials.
    Preview · Article · Mar 2007 · Blood
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: For more than two decades, cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) has been the standard therapy for diffuse large B-cell lymphoma (DLBCL). The addition of rituximab to CHOP has been shown to improve outcome in elderly patients with DLBCL. We conducted a population-based analysis to assess the impact of this combination therapy on adult patients with DLBCL in the province of British Columbia (BC). We compared outcomes during a 3-year period; 18 months before (prerituximab) and 18 months after (postrituximab) institution of a policy recommending the combination of CHOP and rituximab for all patients with newly diagnosed advanced-stage (stage III or IV or stage I or II with "B" symptoms or bulky [> 10 cm] disease) DLBCL. A total of 292 patients were evaluated; 140 in the prerituximab group (median follow-up, 42 months) and 152 in the postrituximab group (median follow-up, 24 months). Both progression-free survival (risk ratio, 0.56; 95% CI, 0.39 to 0.81; P = .002) and overall survival (risk ratio, 0.40; 95% CI, 0.27 to 0.61, P < .0001) were significantly improved in the postrituximab group. After controlling for age and International Prognostic Index score, era of treatment remained a strong independent predictor of progression-free survival (risk ratio, 0.59; 95% CI, 0.41 to 0.85; P = .005) and overall survival (risk ratio, 0.43; 95% CI, 0.29 to 0.66; P < .001). The benefit of treatment in the postrituximab era was present regardless of age. The addition of rituximab to CHOP chemotherapy has resulted in a dramatic improvement in outcome for DLBCL patients of all ages in the province of BC.
    Full-text · Article · Aug 2005 · Journal of Clinical Oncology

Publication Stats

995 Citations
47.50 Total Impact Points


  • 2005-2008
    • University of British Columbia - Vancouver
      • Division of Medical Oncology
      Vancouver, British Columbia, Canada