title: Improvement of long-term survival of colorectal cancer in Japanese-Americans of Hawaii from 1990 to 2001.
abstract: BACKGROUND
  To compare the long-term survival of colorectal cancer (CRC) during two 6-year periods using patients with similar characteristics of the same ethnicity in Hawaii.
  
  
  METHODS
  A retrospective review of Japanese-American patients in Hawaii with CRC surgically resected and followed more than 5 years in a single institution. Patients were divided into two groups by date that patients had surgery: Group 1; 1990-1995, and Group 2; 1996-2001 (introduction of newer chemotherapy, aggressive surgery for liver metastases including radiofrequency thermal ablation).
  
  
  RESULTS
  A total of 344 patients in Group 1 (median age 69.5 years) and 330 patients in Group 2 (median age 71.7 years) were included. There were no differences between two groups in gender, age, anatomic site, carcinoembryonic antigen, tumor size, histologic grade, and TNM stage distribution, including pT, pN, and pM status. Overall 5-year survival rate difference approached significance between two groups (Group 1: 73.2% vs. Group 2: 78.9%; p = 0.097). Particularly, there was significant difference in stage IV patients (Group 1; 8.7% vs. Group 2: 26.0%; p = 0.030) and histologic grade 3 (Group 1; 41.67% vs. Group 2: 67.73%; p = 0.032). Subgroup analyses showed significant difference (p < 0.05) for more advanced cancers (larger tumor, node positive, metastatic disease, poorly differentiated cancer).
  
  
  CONCLUSIONS
  In this study of patients with the same ethnicity, the better survival outcome in latter (Group 2) patients suggests improvement of treatment, especially for patients with more advanced and metastatic cancer (stage IV).
authors.affiliation: Department of Surgery, Kuakini Medical Center, University of Hawaii, Honolulu, HI 96817, USA. masakihata4999@yahoo.co.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Hata
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Janine
authors.initials: J
authors.lastname: Doneza
authors.forename: Kenneth
authors.initials: K
authors.lastname: Sumida
authors.forename: Kiichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Shun
authors.initials: S
authors.lastname: Ishiyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kojima
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tomiki
authors.forename: Junji
authors.initials: J
authors.lastname: Machi
mesh_terms: D000328:Adult; D000368:Aged; D001213:Asian / Q000208:ethnology*; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
chemical_list: D002272:Carcinoembryonic Antigen