Ramos M, Montaño J, Esteva M, Barceló A, Franch P
Mallorca Cancer Registry, Spain.
University of the Balearic Islands, Spain.
Cancer Epidemiol. 2016 Apr;41:63-70. doi: 10.1016/j.canep.2016.01.001. Epub 2016 Jan 29.
To establish cause-specific survival by stage of colorectal cancer up to 8 years from diagnosis, and to identify factors which explain and predict the likelihood of survival.
Retrospective follow-up study of people diagnosed with invasive colorectal cancer during 2006-2011, identified through the Mallorca Cancer Registry. DCO and lymphomas were excluded. Sex, age, diagnostic method, site, histology, T, N, M, and stage, date of diagnosis, date of follow-up or death, and cause of death were collected. End point of follow-up was 31st December 2013. Multiple imputation (MI) method was performed to obtain stage when unknown. Actuarial and Kaplan-Meier methods were used for survival analysis. Extended Cox models were built to identify factors that explain and predict survival.
2889 cases were identified, 41.7% in women and 58.3% in men, with a mean age of 70.5 years. Unknown stage represented 15.3% of cases. After MI, 15% were in stage I, 26.7% were in II, 32.7% in III, and 25.6% in IV. Survival was 56% at the end of the 5th year. Survival by stage changed significantly after MI and was estimated to 83% at stage I, 73% at II, 62% at III, and 16% at IV. Extended Cox model showed that survival worsened with age, mucinous histology, and stage. Risk of dying was 17.0 times higher in stage IV compared to stage I, 3.7 times in stage III, and 1.6 times in stage II.
More than half of colorectal cancer patients will survive 5 years after diagnosis, but only if diagnosed in stages I-III.
确定结直肠癌确诊后长达8年的特定病因生存率，并识别解释和预测生存可能性的因素。
对2006年至2011年期间被诊断为浸润性结直肠癌的患者进行回顾性随访研究，通过马略卡癌症登记处进行识别。排除了同时性结直肠癌和淋巴瘤。收集了性别、年龄、诊断方法、部位、组织学、T、N、M和分期、诊断日期、随访或死亡日期以及死亡原因。随访的终点是2013年12月31日。采用多重填补（MI）方法在分期未知时获取分期。采用精算和Kaplan-Meier方法进行生存分析。构建扩展Cox模型以识别解释和预测生存的因素。
共识别出2889例病例，女性占41.7%，男性占58.3%，平均年龄为70.5岁。分期未知的病例占15.3%。经过MI后，15%处于I期，26.7%处于II期，32.7%处于III期，25.6%处于IV期。第5年末的生存率为56%。MI后各分期的生存率有显著变化，I期估计为83%，II期为73%，III期为62%，IV期为16%。扩展Cox模型显示，生存率随年龄、黏液性组织学和分期而恶化。IV期的死亡风险比I期高17.0倍，III期高3.7倍，II期高1.6倍。
超过一半的结直肠癌患者在确诊后5年能够存活，但前提是在I - III期确诊。
