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Population-based study of factors predicting treatment intention in patients with locally recurrent rectal cancer
- Source :
- British Journal of Surgery. 104:1866-1873
- Publication Year :
- 2017
- Publisher :
- Oxford University Press (OUP), 2017.
-
Abstract
- Background Local recurrence of rectal cancer (LRRC) is associated with poor survival unless curative treatment is performed. The aim of this study was to investigate predictive factors for treatment with curative intent in patients with LRRC. Methods Population-based data for patients treated for primary rectal cancer between 1995 and 2002, and with LRRC reported as first event were collected from the Swedish Colorectal Cancer Registry and medical records. The associations between patient-, primary tumour- and LRRC-related factors and intention of the treatment for LRRC were determined. The impact of the identified predictive factors on prognosis after treatment with curative intent was also assessed. Results A total of 426 patients were included in the study, of whom 149 (35·0 per cent) received treatment with curative intent. Factors significantly associated with treatment of the LRRC with palliative intent were primary surgery with abdominoperineal resection (odds ratio (OR) 5·16, 95 per cent c.i. 2·97 to 8·97), age at diagnosis of LRRC at least 80 years (OR 4·82, 2·37 to 9·80), symptoms at diagnosis (OR 2·79, 1·56 to 5·01) and non-central location of the LRRC (OR 1·79, 1·15 to 2·79). The overall 5-year survival rate was 8·9 per cent for all patients and 23·1 per cent among those treated with curative intent. In patients treated with curative intent, factors associated with increased risk of death were age 80 years or more (hazard ratio (HR) 2·44, 95 per cent c.i. 1·55 to 3·86), presence of symptoms (HR 1·92, 1·20 to 3·05), non-central tumour location (HR 1·51, 1·01 to 2·26) and presence of hydronephrosis (HR 2·02, 1·18 to 3·44). Conclusion Non-central location of the LRRC, presence of symptoms and age at least 80 years at diagnosis of the LRRC were associated with treatment with palliative intent.
- Subjects :
- Male
medicine.medical_specialty
Palliative care
Colorectal cancer
Population
Hydronephrosis
030230 surgery
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Registries
education
Survival rate
Aged
Aged, 80 and over
Sweden
Gynecology
education.field_of_study
Rectal Neoplasms
Abdominoperineal resection
business.industry
Medical record
Palliative Care
Hazard ratio
Age Factors
Odds ratio
Middle Aged
medicine.disease
030220 oncology & carcinogenesis
Female
Surgery
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 13652168 and 00071323
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- British Journal of Surgery
- Accession number :
- edsair.doi.dedup.....8edd67decdeab15da791a3d4acdb02e9