Comorbidity and age as predictors of risk for early mortality of male and female colon carcinoma patients: a population-based study

Survival of korean adult cancer patients by stage at diagnosis, 2006-2010: national cancer registry study

Purpose

Although the cancer stage at diagnosis is the most important prognostic factor for patients' survival, there are few population-based estimates of stage-specific survival outcome, especially in Asian countries. Our study aims to estimate stage-specific survival for Korean patients.

Materials and Methods

We analyzed the Korea National Cancer Incidence Database data on 626,506 adult patients aged ≥ 20 years, who were diagnosed between 2006 and 2010 with stomach, colorectal, liver, lung, breast, cervix, prostate, and thyroid cancers. Patients were followed up to December 2011, and the 5-year relative survival rates (RSRs) were calculated for gender and age group by Surveillance, Epidemiology, and End Results (SEER) stage at diagnosis.

Results

The 5-year RSRs for all localized-stage cancers, except for lung and liver, exceeded 90% with that for thyroid cancer being the highest at 100.4%. These values for distant stage liver, lung, and stomach cancers were very dismal at 2.5%, 4.8%, and 5.5%, respectively, while it was 69.1% for thyroid cancer, and was in the range of 18.3-36.4% for colorectal, cervix, breast and prostate cancers. Overall, the 5-year RSRs for all cancer types decreased with aging across all the disease stages with exception of prostate cancer, which suggests biologic difference in these cancer types in a young age group. When compared with US SEER data, Korean patients had better stage-specific survival rates for stomach, colorectal, liver, and cervical cancers.

Conclusion

Korean cancer patients showed relatively favorable stage distribution and 5-year RSRs, which suggests potential contribution of the national cancer screening program.

Colorectal cancer in geriatric patients: Endoscopic diagnosis and surgical treatment

AIM: To investigate the prevalence of colorectal cancer in geriatric patients undergoing endoscopy and to analyze their outcome.

METHODS: All consecutive patients older than 80 years who underwent lower gastrointestinal endoscopy between January 1995 and December 2002 at our institution were included. Patients with endoscopic diagnosis of colorectal cancer were evaluated with respect to indication, localization and stage of cancer, therapeutic consequences, and survival.

RESULTS: Colorectal cancer was diagnosed in 88 patients (6% of all endoscopies, 55 women and 33 men, mean age 85.2 years). Frequent indications were lower gastrointestinal bleeding (25%), anemia (24%) or sonographic suspicion of tumor (10%). Localization of cancer was predominantly the sigmoid colon (27%), the rectum (26%), and the ascending colon (20%). Stage Dukes A was rare (1%), but Dukes D was diagnosed in 22% of cases. Curative surgery was performed in 54 patients (61.4%), in the remaining 34 patients (38.6%) surgical treatment was not feasible due to malnutrition and asthenia or cardiopulmonary comorbidity (15 patients), distant metastases (11 patients) or refusal of operation (8 patients). Patients undergoing surgery had a very low in-hospital mortality rate (2%). Operated patients had a one-year and three-year survival rate of 88% and 49%, and the survival rates for non-operated patients amounted to 46% and 13% respectively.

CONCLUSION: Nearly two-thirds of 88 geriatric patients with endoscopic diagnosis of colorectal cancer underwent successful surgery at a very low perioperative mortality rate, resulting in significantly higher survival rates. Hence, the clinical relevance of lower gastrointestinal endoscopy and oncologic surgery in geriatric patients is demonstrated.