Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis
| Autor: | Charlie Zhi-Lin Zheng, Yun Xu, Cong Li, Ye Xu, Yuqin Zhang, Fangqi Liu, Tianan Guo |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Survival Colorectal cancer Subgroup analysis lcsh:RC254-282 Gastroenterology Mismatch repair Internal medicine Antineoplastic Combined Chemotherapy Protocols Genetics Biomarkers Tumor Medicine Chemotherapy Humans Propensity Score Retrospective Studies business.industry Cancer Combination chemotherapy Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Prognosis Colorectal Neoplasms Hereditary Nonpolyposis Confidence interval Lynch syndrome Survival Rate Oncology Relative risk Case-Control Studies Propensity score matching Female Neoplasm Recurrence Local business Colorectal Neoplasms Research Article Follow-Up Studies |
| Zdroj: | BMC Cancer BMC Cancer, Vol 21, Iss 1, Pp 1-13 (2021) |
| ISSN: | 1471-2407 |
| Popis: | Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare, with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Between June 2008 and September 2018, a total of 47 patients were diagnosed with LS by genetic testing at Fudan University Shanghai Cancer Center. A 1:2 propensity score matching was performed to obtain homogeneous cohorts from SCRC group. Thereafter, 94 SCRC patients were enrolled as control group. All of enrolled patients received curative surgeries and standardized postoperative monitoring. The long-term survival rates between the two groups were compared, and the prognostic factors were also analyzed. Results The 5-year overall survival rate of LS group was 97.6%, which was significantly higher than of 82.6% for SCRC group (χ2 = 4.745, p = 0.029). The 5-year recurrence free survival rate showed no significant differences between the two groups (78.0% for LS group vs. 70.6% for SCRC patients; χ2 = 1.260, p = 0.262). The 5-year tumor free survival rates in LS group was 62.1% for LS patients, which were significantly lower than of 70.6% for SCRC group (χ2 = 4.258, p = 0.039). Subgroup analysis of recurrent patients show that the LS group had longer overall survival than the SCRC group after combined chemotherapy. By multivariate analysis, we found that tumor recurrence of primary CRC [Risk ratio (95% (confidence interval): 48.917(9.866–242.539); p p = 0.002] were independent risk factors for OS. Conclusion LS patients have better long-term survival prognosis than SCRC patients, even though the two groups have statistically comparable recurrence free survival. Combined chemotherapy is an effective treatment for LS patients who developed primary CRC recurrence. Standardized postoperative monitoring for LS patients may enable detection of metachronous tumors at earlier stages, which was a guarantee of a favorable prognosis despite lower tumor free survival. |
| Databáze: | OpenAIRE |
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