Lavrijssen Birgit D A, Ruiter Rikje, Fest Jesse, Ikram Mohammad A, Stricker Bruno H, van Eijck Casper H J
Department of Surgery, Erasmus Medical Centre, Rotterdam, Netherlands.
Department of Epidemiology, Erasmus Medical Centre, Rotterdam, Netherlands.
Front Oncol. 2022 Feb 16;12:849951. doi: 10.3389/fonc.2022.849951. eCollection 2022.
This study aims to assess trends in patient-related factors and treatment strategies in Dutch colorectal cancer (CRC) patients and their effect on survival.
Data were obtained from the Rotterdam study, an ongoing population-based study of individuals aged ≥45 years. Between 1990 and 2014, incident, pathology-confirmed CRC cases were divided into two groups based on date of diagnosis (either before or after January 1, 2003). Patient characteristics, initial treatment, and date of mortality were collected. Analyses were performed using Kaplan-Meier and Cox proportional hazard models.
Of 14,928 individuals, 272 developed colon cancer and 124 rectal cancer. Median follow-up was 13.2 years. Patients diagnosed after January 1, 2003 were treated chemotherapeutically more often than those diagnosed prior to this date in colon cancer (28.6% vs. 9.1%, = 0.02) and treated more often with chemotherapy (38.6% vs. 12.3%, = 0.02) and radiotherapy (41.3% vs. 10.2%, 0.001) in rectal cancer. Overall survival, adjusted for patient, tumor characteristics, and treatment, improved in rectal cancer (HR, 0.31; 95% CI, 0.13-0.74) but remained stable in colon cancer (HR, 1.28; 95% CI, 0.84-1.95).
Chemotherapeutic agents and radiotherapy are increasingly used in CRC patients. Survival in rectal cancer improved, whereas in colon cancer this was not observed.
本研究旨在评估荷兰结直肠癌（CRC）患者与患者相关因素及治疗策略的趋势及其对生存的影响。
数据来自鹿特丹研究，这是一项正在进行的针对年龄≥45岁个体的基于人群的研究。在1990年至2014年期间，将确诊的、经病理证实的CRC病例根据诊断日期（2003年1月1日之前或之后）分为两组。收集患者特征、初始治疗及死亡日期。使用Kaplan-Meier和Cox比例风险模型进行分析。
在14928名个体中，272人患结肠癌，124人患直肠癌。中位随访时间为13.2年。2003年1月1日之后确诊的结肠癌患者接受化疗的频率高于该日期之前确诊的患者（28.6%对9.1%，P = 0.02），直肠癌患者接受化疗（38.6%对12.3%，P = 0.02）和放疗（41.3%对10.2%，P < 0.001）的频率更高。在对患者、肿瘤特征和治疗进行调整后，直肠癌的总生存率有所提高（HR，0.31；95%CI，0.13 - 0.74），但结肠癌的总生存率保持稳定（HR，1.28；95%CI，0.84 - 1.95）。
化疗药物和放疗在CRC患者中的使用越来越多。直肠癌的生存率有所提高，而结肠癌则未观察到这种情况。
