title: A population-based study elicits a reverse correlation between age and overall survival in elderly patients with rectal carcinoma receiving adjuvant chemotherapy.
abstract: Colorectal cancer is the third most common cancer and the fourth most common cause of cancer-related death globally. This population-based study aimed to explore the predictive factors that affected the overall survival of rectal cancer patients receiving adjuvant chemotherapy plus radical surgery using a Cox proportional hazards modeling approach. A total of 619 patients with rectal cancer who underwent surgery were enrolled between October 2006 and May 2013. Clinical characteristics of the patients were compared among the groups and potential prognostic factors were analyzed using the spss program, version 19.0. Patients aged ≥ 70 years have distinctive characteristics such as lager tumour size (≥ 5 cm), damaged micturition and higher incidence of diabetes compared to younger and middle-aged patients. Male gender, tumour size (≥ 5 cm), poor differentiation, later stage, adjuvant chemotherapy, damaged micturition, hypertension or diabetes are associated with a worse prognosis for rectal cancer patients (P < 0.05). However, smoking is a favourable factor to the patients (P = 0.018). Age of ≥ 70 years is an independent prognostic factor for patients with rectal cancer after surgery (P = 0.000) and elderly patients with Stage II and III disease receiving adjuvant chemotherapy show a favourable prognosis. The elderly patients who suffered from diabetes receiving adjuvant chemotherapy have a poor prognosis. Further prospective and large population studies are warranted to confirm the findings of this study.
authors.affiliation: Cancer Centre, Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China.
authors.forename: Jin-Lu
authors.initials: JL
authors.lastname: Shan
authors.affiliation: Cancer Centre, Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China.|Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.affiliation: Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Centre & Sino-US Joint Laboratory for Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, China.
authors.forename: Zhi-Xu
authors.initials: ZX
authors.lastname: He
authors.affiliation: Cancer Centre, Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Ren
authors.affiliation: Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA.
authors.forename: Shu-Feng
authors.initials: SF
authors.lastname: Zhou
authors.affiliation: Cancer Centre, Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
mesh_terms: D017677:Age Distribution; D000368:Aged; D017024:Chemotherapy, Adjuvant; D048909:Diabetes Complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D012307:Risk Factors; D016019:Survival Analysis
keywords: chemotherapy; elderly patient; prognosis; rectal carcinoma