1994 年至 2004 年期间沙特阿拉伯首项结直肠癌生存数据：下一步是什么？
First national survival data for colorectal cancer among Saudis between 1994 and 2004: what's next?
机构信息
Department of Medicine, Colon Cancer Chair, Faculty of Medicine, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia.
出版信息
BMC Public Health. 2013 Jan 25;13:73. doi: 10.1186/1471-2458-13-73.
BACKGROUND
Colorectal cancer (CRC) is the second most common malignancy in the Saudi population. This study aimed to review CRC data from the Saudi Cancer Registry (SCR) in order to evaluate the prognostic factors for CRC survival in Saudi patients.
METHODS
This study was a retrospective censored overall survival (OS) analysis of CRC data for the period 1994-2004 obtained from the SCR. Data were collected from all 13 administrative regions of the Kingdom of Saudi Arabia (KSA) by the SCR in collaboration with the National Information Center of the Ministry of Interior. The Kaplan-Meier method was used to calculate the cumulative survival rate, which was then stratified by gender and by period (1994-1999 versus 2000-2004). The clinico-pathological variables that might affect CRC survival were analyzed by Cox regression analysis.
RESULTS
Between 1994 and 2004, 549 CRC cases were diagnosed (363 [66.1%] in males and 186 [33.9%] in females). The OS for CRC during this period was 44.6% (44.7% for 1994-1999 and 44.3% for 2000-2004 [p=0.7]). There was a significant (p=0.003) discrepancy of 9.6% between the male five-year OS (41.0%) and the female five-year OS (50.6%). The five-year OS was 63.3% for patients with localized disease, 50.2% for those with regional disease, and 14.7% for patients with metastases. By Cox regression analysis, age and extent were significant prognostic factors of survival in patients with colon cancer; the risk was higher in patients with distant metastasis (hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.17-5.45; p=0.01). In patients with rectal cancer, the risk was lower in males (HR, 0.66; CI, 0.45-0.98; p=0.04), but higher in patients with unknown tumor extent (HR, 3.70; 95% CI, 1.66-8.24; p=0.01).
CONCLUSIONS
The five-year OS for 1994-2004 was 44.6% for patients with CRC. More so, five-year OS based on CRC stage was generally lower than the typically reported survival rates. The establishment of a national screening program and increased access to specialized medical faculties may be necessary to improve CRC survival in the KSA.
背景
结直肠癌（CRC）是沙特人口中第二常见的恶性肿瘤。本研究旨在回顾沙特癌症登记处（SCR）的 CRC 数据，以评估沙特患者 CRC 生存的预后因素。
方法
这是一项对 1994 年至 2004 年期间从 SCR 获得的 CRC 数据进行的回顾性有删失总生存（OS）分析。SCR 通过与内政部国家信息中心合作，从沙特阿拉伯王国（KSA）的 13 个行政区域收集数据。使用 Kaplan-Meier 方法计算累积生存率，然后按性别和时期（1994-1999 年与 2000-2004 年）分层。通过 Cox 回归分析分析可能影响 CRC 生存的临床病理变量。
结果
1994 年至 2004 年间，诊断出 549 例 CRC 病例（男性 363 例[66.1%]，女性 186 例[33.9%]）。在此期间，CRC 的 OS 为 44.6%（1994-1999 年为 44.7%，2000-2004 年为 44.3%[p=0.7]）。男性五年 OS（41.0%）与女性五年 OS（50.6%）之间存在 9.6%的显著差异（p=0.003）。局部疾病患者的五年 OS 为 63.3%，区域疾病患者为 50.2%，转移患者为 14.7%。通过 Cox 回归分析，年龄和程度是结肠癌患者生存的重要预后因素；远处转移患者的风险更高（风险比[HR]，2.53；95%置信区间[CI]，1.17-5.45；p=0.01）。对于直肠癌患者，男性风险较低（HR，0.66；CI，0.45-0.98；p=0.04），但未知肿瘤程度患者的风险较高（HR，3.70；CI，1.66-8.24；p=0.01）。
结论
1994-2004 年 CRC 患者的五年 OS 为 44.6%。此外，基于 CRC 分期的五年 OS 通常低于通常报道的生存率。建立国家筛查计划和增加获得专业医学系的机会可能是提高 KSA CRC 生存率所必需的。
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