Maajani Khadije, Khodadost Mahmoud, Fattahi Arash, Shahrestanaki Ehsan, Pirouzi Aliyar, Khalili Fatemeh, Fattahi Hamed
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Tehran, Iran.Email:
Asian Pac J Cancer Prev. 2019 Jan 25;20(1):13-21. doi: 10.31557/APJCP.2019.20.1.13.
Background: Different studies have been conducted to estimate the survival rate of colorectal cancer in Iran but there is no overall estimate of the survival rate. The aim of this study was to calculate the pooled 1, 3, and 5-year survival rate of the patients with colorectal cancer in Iran. Methods: To retrieve relevant studies, we conducted a systematic search in Iranian databases, including Iran Medex, Magiran, SID, and international databases such as Medlin/PubMed, Scopus, and Google scholar using “Colorectal Neoplasms” and “Survival Rate” as keywords up to December 1st, 2017. We used random effect model to estimate pooled 1, 3, and 5-year survival rates of the patients with colorectal cancer in Iran. To assess the heterogeneity, we used Chi-squared test at the 5 % significance level (p <0.05) and I2 Index. We used meta-regression and subgroup analysis to find a potential source of heterogeneity. Results: After a systematic search, 196 articles were found, of the 38 studies met the eligibility criteria and are included in our meta-analysis. The pooled 1, 3, and 5-year survival rates in patient with colorectal cancer were 0.84 (95% CI: 0.81-0.87), 0.64 (95%CI: 0.59-0.70), and 0.54 (95%CI: 0.49-0.58) respectively. The 5-year survival rate in the subgroup of women was 0.5 (0.44-0.56) and in male subgroup was 0.44 (0.40-0.48). In a subgroup of the tumor site, the 5-year survival rate in colon cancer was 0.6 (0.49-0.75) and rectum cancer was 0.54 (0.36-0.69). In multivariable models, there was a significant association between years of study and 5-year survival rate as a source of heterogeneity (β = 18.9, P=0.01). Conclusion: According to the results of this study, women had a better survival rate than men, and according to the tumor site, the 5-year survival rate in colon cancer was better than the rectum cancer.
伊朗已开展了不同研究来估算结直肠癌的生存率,但尚无生存率的总体估算。本研究的目的是计算伊朗结直肠癌患者的1年、3年和5年合并生存率。方法:为检索相关研究,我们在伊朗数据库(包括伊朗医学数据库、马吉兰数据库、伊朗科学信息数据库)以及国际数据库(如医学索引/医学期刊数据库、Scopus数据库和谷歌学术)中进行了系统检索,使用“结直肠肿瘤”和“生存率”作为关键词,检索截至2017年12月1日的文献。我们采用随机效应模型来估算伊朗结直肠癌患者的1年、3年和5年合并生存率。为评估异质性,我们在5%显著性水平(p<0.05)下使用卡方检验和I²指数。我们采用meta回归和亚组分析来寻找异质性的潜在来源。结果:经过系统检索,共找到196篇文章,其中38项研究符合纳入标准并被纳入我们的meta分析。结直肠癌患者的1年、3年和5年合并生存率分别为0.84(95%CI:0.81 - 0.87)、0.64(95%CI:0.59 - 0.70)和0.54(95%CI:0.49 - 0.58)。女性亚组的5年生存率为0.5(0.44 - 0.56),男性亚组为0.44(0.40 - 0.48)。在肿瘤部位亚组中,结肠癌的5年生存率为0.6(0.49 - 0.75),直肠癌为0.54(0.36 - 0.69)。在多变量模型中,研究年份与作为异质性来源的5年生存率之间存在显著关联(β = 18.9,P = 0.01)。结论:根据本研究结果,女性的生存率高于男性,并且根据肿瘤部位,结肠癌的5年生存率优于直肠癌。