title: Age-dependent improvement in median and long-term survival in unselected population-based Nordic registries of patients with synchronous metastatic colorectal cancer.
abstract: BACKGROUND
  In metastatic colorectal cancer (mCRC) trials, median survival has increased from 6 months to above 20 months during the previous decades. Uncertainty exists in how this survival improvement has translated to the general mCRC population.
  
  
  METHODS
  Survival data from patients with synchronous mCRC were collected from the Norwegian (1980-2008), Swedish (1996-2008) and Danish (2001-09) cancer registries.
  
  
  RESULTS
  A total of 29 628 patients were identified. From 1980-1985 to 2006-2008, median survival increased from 5 to 10 months for Norwegian patients. Three-year survival increased from 7% to 21% and 5-year survival from 4% to 9%. For patients <60 years, median survival was doubled to 16 months, 3-year survival increased fourfold up to 28% and 5-year survival threefold up to 14%. Similar improvements were seen in Sweden and Denmark. In all countries, the improved outcome was seen especially for younger patients and much less for patients >75 years of age.
  
  
  CONCLUSIONS
  An increase in median and long-term survival over time was found in unselected population-based registries of patients with synchronous mCRC. The improved outcome in survival was especially seen in younger patients, raising concerns over our ability to adapt available treatment options for elderly patients.
authors.affiliation: Department of Oncology, Haukeland University Hospital, Bergen, Denmark. halfdan.sorbye@helse-bergen.no
authors.forename: H
authors.initials: H
authors.lastname: Sorbye
authors.forename: M
authors.initials: M
authors.lastname: Cvancarova
authors.forename: C
authors.initials: C
authors.lastname: Qvortrup
authors.forename: P
authors.initials: P
authors.lastname: Pfeiffer
authors.forename: B
authors.initials: B
authors.lastname: Glimelius
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009664:Norway; D012042:Registries; D013534:Survival; D013548:Sweden; D016896:Treatment Outcome
keywords: 5-year survival; cancer registries; elderly; median survival; metastatic colorectal cancer