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Trends in presentation, treatment and survival of 1777 patients with colorectal cancer over a decade: a Biobank study
- Source :
- Acta oncologica (Stockholm, Sweden). 57(6)
- Publication Year :
- 2017
-
Abstract
- Background: Most survival data in colorectal cancer (CRC) is derived from clinical trials or register-based studies. Hospital Biobanks, linked with hospital electronic records, could serve as a data-gathering method based on consecutively collected tumor samples. The aim of this Biobank study was to analyze survival of colorectal patients diagnosed and treated in a single-center university hospital over a period of 12 years, and to evaluate factors contributing to outcome.Material and methods: A total of 1777 patients with CRC treated during 2001-2012 were identified from the Auria Biobank, Turku, Finland. Longitudinal clinical information was collected from various hospital electronic records and date and cause of death obtained from Statistics Finland.Results: Cancer-specific, overall and disease-free survival was higher in patients diagnosed during 2004-2008 as compared with patients diagnosed in 2001-2003. Further improvement was not seen during years 2009-2012. Potential factors contributing to the improvement were introduction of multidisciplinary meetings, centralization of rectal cancer surgery, use of adjuvant chemotherapy and systematic preoperative radiotherapy of rectal cancer. The proportion of patients with stage I-IV CRC remained similar over the study period, but a marked decrease in non-metastatic rectal cancer with biopsy only (locally advanced disease) was observed. In stage I-III rectal cancer, Cox multivariate analysis suggested age, comorbidity, R1 resection, T staging and tumor grade as prognostic factors. In colon cancer, prognostic factors were age, comorbidity, gender and presence of lymph node metastases.Conclusions: Organizational changes in the treatment of CRC patients made since 2004 coincide with improved survival in CRC and a marked reduction in locally advanced rectal cancers. The clinical presentation of CRC has remained similar between 2001 and 2012.
- Subjects :
- Male
Colorectal cancer
STAGE-II
Kaplan-Meier Estimate
Medical Oncology
law.invention
0302 clinical medicine
Randomized controlled trial
law
Electronic Health Records
ADVANCED RECTAL-CANCER
Finland
Cause of death
Aged, 80 and over
OUTCOMES
Hematology
General Medicine
Middle Aged
Biobank
3. Good health
Oncology
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
CLINICAL-PRACTICE GUIDELINES
Presentation (obstetrics)
Colorectal Neoplasms
Adult
medicine.medical_specialty
RANDOMIZED CONTROLLED-TRIALS
3122 Cancers
MEDLINE
Disease-Free Survival
POOLED ANALYSIS
03 medical and health sciences
III COLON-CANCER
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
METAANALYSIS
Aged
Proportional Hazards Models
ta3126
Proportional hazards model
business.industry
medicine.disease
ta3122
FLUOROURACIL
Clinical trial
business
FOLLOW-UP
Subjects
Details
- ISSN :
- 1651226X and 20012012
- Volume :
- 57
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Acta oncologica (Stockholm, Sweden)
- Accession number :
- edsair.doi.dedup.....1827f04e835cf15d04ac7484d40470c1