Patient and disease characteristics, treatment practices and oncologic outcomes among patients with colorectal cancer: a population-based analysis.

Autor:	Farooq A; From the Department of Surgery, University of Calgary, Calgary, Alta. (Farooq, Keehn, Xu, Kong, Quan, MacLean); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Keehn, Xu, Kong, Cheung, Quan); and the Department of Oncology, University of Calgary, Calgary, Alta. (Xu, Kong, Cheung, Quan)., Keehn AR; From the Department of Surgery, University of Calgary, Calgary, Alta. (Farooq, Keehn, Xu, Kong, Quan, MacLean); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Keehn, Xu, Kong, Cheung, Quan); and the Department of Oncology, University of Calgary, Calgary, Alta. (Xu, Kong, Cheung, Quan)., Xu Y; From the Department of Surgery, University of Calgary, Calgary, Alta. (Farooq, Keehn, Xu, Kong, Quan, MacLean); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Keehn, Xu, Kong, Cheung, Quan); and the Department of Oncology, University of Calgary, Calgary, Alta. (Xu, Kong, Cheung, Quan)., Kong S; From the Department of Surgery, University of Calgary, Calgary, Alta. (Farooq, Keehn, Xu, Kong, Quan, MacLean); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Keehn, Xu, Kong, Cheung, Quan); and the Department of Oncology, University of Calgary, Calgary, Alta. (Xu, Kong, Cheung, Quan)., Cheung WY; From the Department of Surgery, University of Calgary, Calgary, Alta. (Farooq, Keehn, Xu, Kong, Quan, MacLean); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Keehn, Xu, Kong, Cheung, Quan); and the Department of Oncology, University of Calgary, Calgary, Alta. (Xu, Kong, Cheung, Quan)., Quan ML; From the Department of Surgery, University of Calgary, Calgary, Alta. (Farooq, Keehn, Xu, Kong, Quan, MacLean); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Keehn, Xu, Kong, Cheung, Quan); and the Department of Oncology, University of Calgary, Calgary, Alta. (Xu, Kong, Cheung, Quan)., MacLean AR; From the Department of Surgery, University of Calgary, Calgary, Alta. (Farooq, Keehn, Xu, Kong, Quan, MacLean); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Keehn, Xu, Kong, Cheung, Quan); and the Department of Oncology, University of Calgary, Calgary, Alta. (Xu, Kong, Cheung, Quan) tony.maclean@albertahealthservices.ca.
Jazyk:	angličtina
Zdroj:	Canadian journal of surgery. Journal canadien de chirurgie [Can J Surg] 2023 Feb 15; Vol. 66 (1), pp. E71-E78. Date of Electronic Publication: 2023 Feb 15 (Print Publication: 2023).
DOI:	10.1503/cjs.024320
Abstrakt:	Background: The incidence of colorectal cancer (CRC) is increasing among young adults. We sought to report on patient and disease characteristics, treatment practice patterns and outcomes in this population. Methods: We conducted a retrospective cohort study using administrative health data from the Alberta Cancer Registry (2004-2015), including demographic and tumour characteristics, and treatment received. Outcome measures included overall and cancer-specific deaths. We used Cox regression and Kaplan-Meier curves to assess for factors associated with survival. Results: We included 18 070 patients with CRC ( n = 1583 [8.8%] < 50 yr, n = 16 487 [91.2 %] ≥ 50 yr). Younger patients were more likely to present with locally advanced disease (21.0% v. 18.0%, p < 0.0001), stage III (16.4 % v. 14.6%, p < 0.0001) or metastatic (16.7% v. 13.8%, p < 0.0001) involvement. Younger patients were more likely to receive surgery (87.2% v. 80.9%, p < 0.0001), chemotherapy (59.6% v. 34.1%, p < 0.0001) or radiation therapy (49.5% v. 37.2%, p < 0.001). At 5 years, overall and cancer-specific survival was better among younger patients than older patients (30.6% v. 51.5% overall deaths, 27.5% v. 38.4% cancer-specific deaths, p < 0.0001). Conclusion: Despite higher stage and higher grade disease, young patients with CRC had more favourable oncologic outcomes than stage-matched older patients, which may be related to younger patients receiving more aggressive treatment. Further investigation should focus on optimal treatment patterns for young patients with CRC. Competing Interests: Competing interests: Ameer Farooq is the associate digital editor for CJS; he was not involved in the review or decision to accept this manuscript for publication. He is also codirector of social media for Evidence Based Reviews in Surgery. No other competing interests were declared. (© 2023 CMA Impact Inc. or its licensors.)
Databáze:	MEDLINE
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