Colorectal Cancer Demographics and Survival in a London Cancer Network (original) (raw)
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Predictive factors of years of potential life lost by colorectal cancer
European Journal of Gastroenterology & Hepatology, 2008
Objective To evaluate the impact of colorectal cancer (CRC) by estimating the years of potential life lost (YPLL) by this neoplasm in a cohort of patients, as well as to define the predictive factors of YPLL. Methods A descriptive cross-sectional study of 980 consecutive patients diagnosed and treated because of CRC in our institution between 1985 and 2002 was carried out. Demographic, clinical, pathological, surgical, hospital stay, complications, and mortality variables were recorded. The primary endpoint of this study was to calculate individual YPLL. Univariate analysis was performed to compare each independent variable with the variable YPLL. All clinically relevant variables significantly associated with YPLL were included in an ordinal regression model to identify independent factors prognostic of YPLL. Results The final study sample was 794 patients, 413 (52%) men and 381 (48%) women, mean age 65.3 years [confidence interval (CI) 95%: 64.4-66.2 years; SD: 12.8]. The mean global YPLL for the 351 patients who died of CRC was 15.2 years (SD: 10.7; CI 95%: 14.1-16.3). Lower age [odds ratio (OR) = 0.98; CI 95%: 0.97-0.98], male sex (OR = 1.19; CI 95%: 1.00-1.43), lower tumor, nodes, metastasis (TNM) stage (OR = 0.29; CI 95%: 0.24-0.35), and rectum localization of the tumor (OR = 1.37; CI 95%: 1.14-1.64) were independent prognostic factors for YPLL. Conclusion In our community, the mean number of YPLL by CRC exceeds 15 years. Lower age, male sex, higher TNM stage, and rectum localization are negative predictors of YPLL.
Five-year follow-up mortality prognostic index for colorectal patients
International Journal of Colorectal Disease
Purpose To identify 5-year survival prognostic variables in patients with colorectal cancer (CRC) and to propose a survival prognostic score that also takes into account changes over time in the patient’s health-related quality of life (HRQoL) status. Methods Prospective observational cohort study of CRC patients. We collected data from their diagnosis, intervention, and at 1, 2, 3, and 5 years following the index intervention, also collecting HRQoL data using the EuroQol-5D-5L (EQ-5D-5L), European Organization for Research and Treatment of Cancer’s Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30), and Hospital Anxiety and Depression Scale (HADS) questionnaires. Multivariate Cox proportional models were used. Results We found predictors of mortality over the 5-year follow-up to be being older; being male; having a higher TNM stage; having a higher lymph node ratio; having a result of CRC surgery classified as R1 or R2; invasion of neighboring organs; having a higher score on th...
Introduction: A generalized structural equation model with accelerated failure time for survival analysis in predicting early recurrence and mortality following curative surgery in colorectal cancer patients. Methods: This retrospective cohort study included 284 patients with colorectal cancer who underwent surgery at Imam Khomeini Clinic in Hamadan between 2001 and 2017. Demographic and other relevant data were extracted from patient records, including age at diagnosis, sex, clinical and pathological variables, first treatment type and date, tumor differentiation degree, disease stage, and treatment types (surgery, chemotherapy, and radiotherapy). Predictors were included in a generalized structural equation model for survival analysis with an accelerated failure time (AFT) model, and both unadjusted and adjusted time ratios (TRs) were calculated. Results: The study findings indicate that patients who did not receive chemotherapy had a lower survival time ratio [TR=0.443, 0.307 - 0...
World Journal of Surgical Oncology
Background The aim of this study was to identify predictors of mortality in elderly patients undergoing colorectal cancer surgery and to develop a risk score. Methods This was an observational prospective cohort study. Individuals over 80 years diagnosed with colorectal cancer and treated surgically were recruited in 18 hospitals in the Spanish National Health Service, between June 2010 and December 2012, and were followed up 1, 2, 3, and 5 years after surgery. Sociodemographic and clinical data were collected. The primary outcomes were mortality at 2 and between 2 and 5 years after the index admission. Results The predictors of mortality 2 years after surgery were haemoglobin ≤ 10 g/dl and colon locations (HR 1.02; CI 0.51–2.02), ASA class of IV (HR 3.55; CI 1.91–6.58), residual tumour classification of R2 (HR 7.82; CI 3.11–19.62), TNM stage of III (HR 2.14; CI 1.23–3.72) or IV (HR 3.21; CI 1.47–7), LODDS of more than − 0.53 (HR 3.08; CI 1.62–5.86)) and complications during admissi...
Long-term Net Survival in Patients With Colorectal Cancer in France
Diseases of the Colon & Rectum, 2013
BACKGROUND: net survival, the survival that might occur if cancer was the only cause of death, is a major epidemiological indicator. Recent findings have shown that the classical methods used for the estimation of net survival from cancer registry data, referred as to "relativesurvival methods," provided biased estimates. OBJECTIVES: the aim of this study was to provide, for the first time, long-term net survival rates for colorectal cancer by using a population-based digestive cancer registry. DESIGN: this study is a population-based cancer registry analysis. the recently proposed unbiased nonparametric Pohar-Perme estimator was used. PATIENTS: overall, 14,715 colorectal cancers diagnosed between 1976 and 2005 and registered in the populationbased digestive cancer registry of Burgundy (france) were included. MAIN OUTCOME MEASURES: the primary outcome measured was cancer net survival, ie, the survival that might occur if all risks of dying of other causes than cancer were removed RESULTS: ten-year net survival increased from 31% during the 1976 to 1985 period to 47% during the 1986 to 1995 period and then leveled out (48% during the 1996-2005 period). there was a major improvement in 10-year net survival after resection for cure and for stage i to iii. it was striking for stage iii cancers, for which 10-year net survival increased from 21% (1976-1985) to 49% (1996-2005). the corresponding net survivals were 70% and 87% for stage i and 49% and 65% for stage ii. these trends can be related to the decrease in operative mortality, the increase in the proportion of patients resected for cure, and the improvement in stage at diagnosis. they were mainly seen between 1976 and 1995, explaining why survival leveled out after 1995. LIMITATIONS: the study was limited by its retrospective and population-based nature. CONCLUSIONS: further improvements for colorectal cancer management can be expected from more effective treatments and from the implementation of organized cancer screening.
Predictors of Survival Among Colorectal Cancer Patients in a Low Incidence Area
Cancer Management and Research
Background: Colorectal cancer is the third most common malignancy in Saudi Arabia. The best therapeutic regimen for colorectal cancer is a matter of ongoing debate and data on its treatment in Saudi Arabia are limited. Purpose: The objective of this study was to explore the predictors of survival and to compare the risk of mortality among colorectal cancer patients treated with different therapeutic modalities. Patients and Methods: The study utilized data from the electronic colorectal cancer registry of a university-affiliated tertiary care hospital. The Kaplan-Meier survival analysis was used to estimate the survival rates over 36 months of follow-up across rectal and colon cancer patients as well as different sociodemographic and medical characteristics. Bivariate and multiple Cox proportional-hazards regressions were conducted to estimate the risk of mortality among rectal and colon cancer patients undergoing different treatments. Results: The number of patients in the registry who were followed up for 36 months was 143 patients. The majority of patients had colon cancer (74.13%). Rectal cancer patients had generally better survival estimates compared to their colon cancer counterparts. Colon cancer patients treated with chemotherapy had a significantly lower risk of mortality controlling for the use of surgery, radiotherapy, and other variables including age, gender, stage of cancer, and family history of colorectal cancer (HR=0.33; P=0.03). Additionally, colon cancer patients with a family history of colorectal cancer had significantly higher risk of mortality (HR=3.40; P=0.02). Conclusion: The findings of this study highlight the value of chemotherapy in managing colon cancer patients.
Most colorectal cancer survivors live a large proportion of their remaining life in good health
Cancer Causes & Control, 2012
Purpose Colorectal cancer (CRC) diagnosis reduces life expectancy and decreases patients' well-being. We sought to assess the determinants of health and functional status and estimate the proportion of remaining life that CRC survivors would spend in good health. Methods Using Sullivan method, healthy life expectancy was calculated based on survival data of 14,849 CRC survivors within a population-based cancer registry in southern Netherlands and quality of life information among a random sample of these survivors (n = 1,291). Results Overall, albeit short life expectancy (LE at age 50 = 12 years for males and 13 years for females), most CRC survivors spent a large proportion of their remaining life in good health (74 and 77 %, for males and females, respectively). Long-term survivors may expect to live a normal life span (LE at age 50 = 30 years) and spent a large proportion of the remaining life in good health (78 %). In distinction, those with stage IV CRC had less than 2 years to live and spent more than half of their remaining life in poor health. Conclusions Most CRC patients may expect no compromise on living a healthy life, underlining the importance of early detection. On the other hand, the high proportion of non-healthy years among stage IV CRC survivors confirms the importance of early detection and palliative care.
Differences in the survival rates of older patients with colorectal cancers in 2003 and 2009
Annals of surgical treatment and research, 2017
The aim of this study was to investigate survival in patients aged ≥70 years who underwent colorectal cancer surgery in 2003 and 2009. In addition, we aimed to identify the factors that could affect survival in these patients. In a cross-sectional study, a retrospective review of the data for 878 patients who underwent colorectal cancer surgery with curative intent in the years 2003 and 2009 was performed. The primary outcome was the 5-year overall survival rate (5-OSR), and the clinicopathologic factors that could affect overall survival were analyzed. The 5-OSR was 77.8% and 84.9% in 2003 and 2009, respectively (P = 0.013). Age, American Society of Anesthesiologists physical status classification, stage, type of surgery, and length of hospital stay possibly affected survival per the univariate and multivariate analyses. In patients aged ≥70 years, the 5-OSR in 2009 was 75.9%, which showed improvement compared to 53.7% in 2003 (P = 0.027). The stage, type of surgery, and hospital s...