Hospital-based colorectal cancer survival trend of different tumor locations from 1960s to 2000s.
BACKGROUND
Our aim is to explore the trend of association between the survival rates of colorectal cancer (CRC) and the different clinical characteristics in patients registered from 1960s to 2000s. We hypothesized that the survival rate of CRC increases over time and varies according to anatomic subsites.


METHODS
Information from a total of 4558 stage T(1-4)N(1-2)M0 CRC patients registered from 1960s to 2008 were analyzed. The association of CRC overall survival with age, gender, tumor locations, time, histopathology types, pathology grades, no. of examined lymph nodes, the T stage, and the N stage was analyzed. The assessment of the influence of prognostic factors on patient survival was performed using Cox's proportional hazard regression models.


RESULTS
From 1960 to 2008, the studied CRC patients included 2625 (57.6%) and 1933 (42.4%) males and females, respectively. These included 1896 (41.6%) colon cancers, and 2662 (58.4%) rectum cancers. The 5-year survival rate was 49%, 58%, 58%, 70%, and 77% for the time duration of 1960s, 1970s, 1980s, 1990s and 2000s, respectively. An increased 5-year survival rate was observed in the colon cancer and rectum cancer patients. Patients older than 60 years of age were more likely to develop colonic cancer (sigmoid) than rectum cancer (49.2% vs. 39.9%). The Cox regression model showed that only rectum cancer survival was related to time duration.


CONCLUSIONS
The overall survival and 5-year survival rates showed an increase from the 1960s to 2000s. There is a trend of rightward shift of tumor location in CRC patients.
Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China ; State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.
Yu-Jing
YJ
Fang
Xiao-Jun
XJ
Wu
Qian
Q
Zhao
Li-Ren
LR
Li
Zhen-Hai
ZH
Lu
Pei-Rong
PR
Ding
Rong-Xin
RX
Zhang
Ling-Heng
LH
Kong
Fu-Long
FL
Wang
Jun-Zhong
JZ
Lin
Gong
G
Chen
Zhi-Zhong
ZZ
Pan
De-Sen
DS
Wan
D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000401:mortality; D015179:Colorectal Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000401:mortality; D015996:Survival Rate