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哥伦比亚麦德林回顾性队列研究:早发性和迟发性结直肠癌的临床和病理差异,以及晚期患者一年全因死亡率的决定因素。

Clinical and pathological differences between early- and late-onset colorectal cancer and determinants of one-year all-cause mortality among advanced-stage patients: a retrospective cohort study in Medellín, Colombia.

机构信息

Semillero de Investigación en Salud (SEIS), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia.

Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

出版信息

Cancer Treat Res Commun. 2024;39:100797. doi: 10.1016/j.ctarc.2024.100797. Epub 2024 Feb 15.

Abstract

OBJECTIVE

To identify the differences between early- (EOCRC) and late-onset colorectal cancer (LOCRC), and to evaluate the determinants of one-year all-cause mortality among advanced-stage patients.

METHODS

A retrospective cohort study was carried out. CRC patients ≥ 18 years old were included. Chi-Square test was applied to compare both groups. Uni- and multivariate regressions were performed to evaluate the determinants of one-year all-cause mortality in all advanced-stage patients regardless of age of onset.

RESULTS

A total of 416 patients were enrolled; 53.1 % were female. Ninety cases (21.6 %) had EOCRC and 326 (78.4 %) had LOCRC. EOCRC cases were predominantly sporadic (88.9 %). Histology of carcinoma other than adenocarcinoma (p= 0.044) and rectum tumors (p= 0.039) were more prevalent in EOCRC. LOCRC patients were more likely to have smoking history (p < 0.001) and right colon tumors (p = 0.039). Alcohol consumption history (odds ratio [OR]: 3.375, 95 %CI: 1.022-11.150) and stage IV (OR: 12.632, 95 %CI: 3.506-45.513) were associated with higher one-year all-cause mortality among advanced-stage patients, the opposite was noted with left colon tumors (OR: 0.045, 95 %CI: 0.003-0.588).

CONCLUSION

EOCRC was predominantly sporadic and had more cases of uncommon histological subtypes and rectal tumors. LOCRC was characterized by a higher prevalence of smoking history. Multivariate regression revealed an association between higher one-year all-cause mortality and alcohol consumption history and stage IV in advanced-stage patients. CRC exhibited differences based on age of onset. The evaluated factors associated with CRC mortality provide valuable insights for healthcare professionals, emphasizing the importance of adequate clinical assessment and early CRC diagnosis.

摘要

目的

确定早发性(EOCRC)和迟发性结直肠癌(LOCRC)之间的差异,并评估晚期患者一年内全因死亡率的决定因素。

方法

进行了一项回顾性队列研究。纳入年龄≥18 岁的 CRC 患者。应用卡方检验比较两组。对所有晚期患者(不论发病年龄)进行单因素和多因素回归,以评估一年内全因死亡率的决定因素。

结果

共纳入 416 例患者,其中 53.1%为女性。90 例(21.6%)为 EOCRC,326 例(78.4%)为 LOCRC。EOCRC 病例主要为散发性(88.9%)。EOCRC 中更常见非腺癌(p=0.044)和直肠肿瘤(p=0.039)。LOCRC 患者更可能有吸烟史(p<0.001)和右半结肠癌(p=0.039)。饮酒史(比值比[OR]:3.375,95%CI:1.022-11.150)和 IV 期(OR:12.632,95%CI:3.506-45.513)与晚期患者一年内全因死亡率升高相关,而左半结肠癌(OR:0.045,95%CI:0.003-0.588)则相反。

结论

EOCRC 主要为散发性,且更常见非典型组织学亚型和直肠肿瘤。LOCRC 以吸烟史更为常见。多因素回归显示,晚期患者一年内全因死亡率与饮酒史和 IV 期相关。CRC 根据发病年龄存在差异。评估的与 CRC 死亡率相关的因素为医疗保健专业人员提供了有价值的见解,强调了充分的临床评估和早期 CRC 诊断的重要性。

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