Digestive Cancer Registry of Burgundy, Dijon, France.
French Network of Cancer Registries (FRANCIM), Dijon, France.
Int J Cancer. 2024 Sep 1;155(5):807-815. doi: 10.1002/ijc.34944. Epub 2024 Apr 5.
Recurrence after colorectal cancer resection is rarely documented in the general population while a key clinical determinant for patient survival. We identified 8785 patients with colorectal cancer diagnosed between 2010 and 2013 and clinically followed up to 2020 in 15 cancer registries from seven European countries (Bulgaria, Switzerland, Germany, Estonia, France, Italy, and Spain). We estimated world age-standardized net survival using a flexible cumulative excess hazard model. Recurrence rates were calculated for patients with initially resected stage I, II, or III cancer in six countries, using the actuarial survival method. The proportion of nonmetastatic resected colorectal cancers varied from 58.6% to 78.5% according to countries. The overall 5-year net survival by country ranged between 60.8% and 74.5%. The absolute difference between the 5-year survival extremes was 12.8 points for stage II (Bulgaria vs Switzerland), 19.7 points for stage III (Bulgaria vs. Switzerland) and 14.8 points for Stage IV and unresected cases (Bulgaria vs. Switzerland or France). Five-year cumulative rate of recurrence among resected patients with stage I-III was 17.7%. As compared to the mean of the whole cohort, the risk of developing a recurrence did not differ between countries except a lower risk in Italy for both stage I/II and stage III cancers and a higher risk in Spain for stage III. Survival after colorectal cancer differed across the concerned European countries while there were slight differences in recurrence rates. Population-based collection of cancer recurrence information is crucial to enhance efforts for evidence-based management of colorectal cancer follow up.
在一般人群中，结直肠癌切除后的复发很少有记录，但这是患者生存的一个关键临床决定因素。我们在 7 个欧洲国家（保加利亚、瑞士、德国、爱沙尼亚、法国、意大利和西班牙）的 15 个癌症登记处确定了 8785 名在 2010 年至 2013 年期间诊断并在临床随访至 2020 年的结直肠癌患者。我们使用灵活的累积超额风险模型估计了世界年龄标准化的净生存率。在六个国家，我们使用 actuarial 生存法计算了最初接受 I 期、II 期或 III 期癌症切除的患者的复发率。根据国家的不同，非转移性切除结直肠癌的比例从 58.6%到 78.5%不等。不同国家的 5 年总净生存率在 60.8%到 74.5%之间。根据国家的不同，II 期（保加利亚与瑞士）的 5 年生存极值之间的绝对差异为 12.8 分，III 期（保加利亚与瑞士）为 19.7 分，IV 期和未切除病例为 14.8 分（保加利亚与瑞士或法国）。I-III 期切除患者的 5 年累积复发率为 17.7%。与整个队列的平均值相比，除了意大利 I/II 期和 III 期癌症的风险较低以及西班牙 III 期癌症的风险较高外，各国之间发生复发的风险没有差异。结直肠癌患者的生存情况在涉及的欧洲国家之间存在差异，而复发率则略有不同。结直肠癌复发信息的人群收集对于提高结直肠癌随访的循证管理努力至关重要。
