Relative survival is an adequate estimate of cancer-specific survival: baseline mortality-adjusted 10-year survival of 771 rectal cancer patients
| Autor: | Daniel Horber, Alexis Ulrich, Thomas Cerny, Ulrich Güller, Philipp Achermann, Rene Warschkow, Zeno Stanga, Ignazio Tarantino, Bruno M. Schmied |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Colorectal cancer Population 610 Medicine & health Risk Factors Internal medicine Humans Medicine education Survival rate Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies education.field_of_study Relative survival Rectal Neoplasms business.industry Proportional hazards model Cancer Retrospective cohort study Prognosis medicine.disease Confidence interval Surgery Survival Rate Oncology Female business Follow-Up Studies |
| Zdroj: | Tarantino, Ignazio; Achermann, Philipp; Güller, Ulrich; Ulrich, Alexis; Schmied, Bruno M; Horber, Daniel; Cerny, Thomas; Stanga, Zeno; Warschkow, Rene (2013). Relative survival is an adequate estimate of cancer-specific survival: baseline mortality-adjusted 10-year survival of 771 rectal cancer patients. Annals of surgical oncology, 20(12), pp. 3877-3884. Springer 10.1245/s10434-013-3173-5 |
| Popis: | BACKGROUND The objective of the present investigation is to assess the baseline mortality-adjusted 10-year survival of rectal cancer patients. METHODS Ten-year survival was analyzed in 771 consecutive American Joint Committee on Cancer (AJCC) stage I-IV rectal cancer patients undergoing open resection between 1991 and 2008 using risk-adjusted Cox proportional hazard regression models adjusting for population-based baseline mortality. RESULTS The median follow-up of patients alive was 8.8 years. The 10-year relative, overall, and cancer-specific survival were 66.5% [95% confidence interval (CI) 61.3-72.1], 48.7% (95% CI 44.9-52.8), and 66.4% (95% CI 62.5-70.5), respectively. In the entire patient sample (stage I-IV) 47.3% and in patients with stage I-III 33.6 % of all deaths were related to rectal cancer during the 10-year period. For patients with AJCC stage I rectal cancer, the 10-year overall survival was 96% and did not significantly differ from an average population after matching for gender, age, and calendar year (p = 0.151). For the more advanced tumor stages, however, survival was significantly impaired (p < 0.001). CONCLUSIONS Retrospective investigations of survival after rectal cancer resection should adjust for baseline mortality because a large fraction of deaths is not cancer related. Stage I rectal cancer patients, compared to patients with more advanced disease stages, have a relative survival close to 100% and can thus be considered cured. Using this relative-survival approach, the real public health burden caused by rectal cancer can reliably be analyzed and reported. |
| Databáze: | OpenAIRE |
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