加拿大艾伯塔省早发性结直肠癌患者的治疗模式和生存结局：一项基于人群的研究。

Treatment patterns and survival outcomes of early-onset colorectal cancer patients in Alberta, Canada: a population-based study.

机构信息

Department of Community Health Sciences, University of Calgary, Calgary, AB; Department of Oncology, University of Calgary, Calgary, AB; Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, AB.

Department of Community Health Sciences, University of Calgary, Calgary, AB; Department of Oncology, University of Calgary, Calgary, AB.

出版信息

Cancer Treat Res Commun. 2022;32:100585. doi: 10.1016/j.ctarc.2022.100585. Epub 2022 Jun 3.

DOI:10.1016/j.ctarc.2022.100585

PMID:35679754

Abstract

BACKGROUND

The incidence of early-onset (<50) colorectal cancer (eoCRC) has been increasing in Canada. Little is known about treatment patterns and outcomes among this patient population in Canada.

PATIENTS AND METHODS

We conducted a retrospective population-based cohort study of CRC patients in Alberta (2010-2018) using electronic medical records and administrative claims data. Treatment patterns and CRC-specific mortality were compared between early-onset age groups (<40 and 40-49) and average age-at-onset (60-70) (aoCRC) patients with multivariable logistic regression and cox proportional hazard models.

RESULTS

There were 334 and 935 patients in the early-onset groups and 4606 in the aoCRC group. Compared with aoCRC, patients <40 were more likely to receive chemotherapy in stage II colon (OR 3.41, CI 1.75-6.47) and stage III rectal (OR 3.01, CI 1.18-10.21), and to receive systemic therapy (OR 2.40, CI 1.46-4.12) and radiation in stage IV CRC (OR 2.70, CI 1.48-4.92). The 40-49 age group was more likely to receive chemotherapy in stage II colon (OR 2.13, CI 1.25-3.56), and chemoradiation in stage II rectal (OR 2.16, CI 1.25-3.80) and stage III rectal (OR 1.63, CI 1.13-2.40), as well as systemic therapy in stage IV CRC (OR 2.46, CI 1.75-3.52). Survival did not differ between <40 and 60-70 age groups. Survival was significantly higher for the 40-49 age group, but only in stage IV (HR 0.79, CI 0.67-0.94).

CONCLUSIONS

EoCRC patients tended to receive more therapy than average age CRC patients with minimal survival gains. Additional research to identify optimal treatment strategies for eoCRC patients is required.

摘要

背景

在加拿大，早发性（<50 岁）结直肠癌（eoCRC）的发病率一直在上升。对于加拿大这一患者群体的治疗模式和结局，我们知之甚少。

患者和方法

我们使用电子病历和行政索赔数据，对艾伯塔省（2010-2018 年）的 CRC 患者进行了回顾性基于人群的队列研究。我们使用多变量逻辑回归和 Cox 比例风险模型比较了早发年龄组（<40 岁和 40-49 岁）和平均发病年龄组（60-70 岁）（aoCRC）患者的治疗模式和 CRC 特异性死亡率。

结果

早发组各有 334 例和 935 例患者，aoCRC 组有 4606 例患者。与 aoCRC 相比，<40 岁的患者在 II 期结肠癌（OR 3.41，95%CI 1.75-6.47）和 III 期直肠癌（OR 3.01，95%CI 1.18-10.21）中更有可能接受化疗，在 IV 期 CRC（OR 2.40，95%CI 1.46-4.12）中更有可能接受全身治疗和放疗，在 IV 期 CRC（OR 2.70，95%CI 1.48-4.92）中更有可能接受化疗。40-49 岁年龄组在 II 期结肠癌（OR 2.13，95%CI 1.25-3.56）、II 期直肠癌（OR 2.16，95%CI 1.25-3.80）和 III 期直肠癌（OR 1.63，95%CI 1.13-2.40）中更有可能接受化疗，在 IV 期 CRC（OR 2.46，95%CI 1.75-3.52）中更有可能接受全身治疗。<40 岁和 60-70 岁年龄组之间的生存情况无差异。40-49 岁年龄组的生存率显著提高，但仅在 IV 期（HR 0.79，95%CI 0.67-0.94）。