Division of Surgical Oncology, Erasmus University MC, Daniel den Hoed Cancer Center, Rotterdam, the Netherlands.
Colorectal Dis. 2012 Jan;14(1):56-61. doi: 10.1111/j.1463-1318.2010.02539.x.
The incidence, patterns of care and survival were determined in patients with stage IV colorectal cancer (CRC) in a population-based series.
Computer records for patients diagnosed with stage IV CRC diagnosed from 1 January 1995 to 31 December 2007 were retrieved from the Rotterdam Cancer Registry. Surgical resection of the primary tumour, chemotherapy use, hepatic surgery and survival were evaluated according to year of diagnosis, age, gender and primary tumour site.
In the southwestern part of the Netherlands, 19 014 new patients with CRC were diagnosed and synchronous metastatic disease was found in 3482 (18%). This proportion increased during the study period, from 16% to 21%. Surgical resection of the primary tumour was performed in approximately 50% of the patients and did not change over time. Postoperative 30-day mortality was 8%. Chemotherapy use increased from 18% in the first period to 56% in the latest period. Liver surgery increased from 4% in the first period to 10% in the latest period. Median survival increased from 7 months to 12 months and 2-year survival increased from 14% to 28%. Two-year survival declined with increasing age and was significantly worse for right-sided tumours (14%).
Survival of patients with stage IV CRC has improved over time and this is probably a result of the increased use of chemotherapy and the increased numbers of patients who underwent hepatic surgery.
在基于人群的系列研究中，确定了 IV 期结直肠癌（CRC）患者的发病情况、治疗模式和生存率。
从 1995 年 1 月 1 日至 2007 年 12 月 31 日，从鹿特丹癌症登记处检索到诊断为 IV 期 CRC 的患者的计算机记录。根据诊断年份、年龄、性别和原发肿瘤部位，评估了原发肿瘤切除术、化疗使用、肝切除术和生存情况。
在荷兰西南部，诊断出 19014 例新的 CRC 患者，其中 3482 例（18%）存在同步转移疾病。在研究期间，这一比例从 16%增加到 21%。大约 50%的患者接受了原发肿瘤切除术，且该比例没有随时间变化。术后 30 天死亡率为 8%。化疗使用率从第一阶段的 18%增加到最后阶段的 56%。肝切除术从第一阶段的 4%增加到最后阶段的 10%。中位生存时间从 7 个月增加到 12 个月，2 年生存率从 14%增加到 28%。2 年生存率随年龄增加而下降，右半结肠癌患者的生存率明显较差（14%）。
IV 期 CRC 患者的生存率随着时间的推移有所提高，这可能是由于化疗使用率的增加和接受肝切除术的患者数量增加所致。
