Survival of metastatic colorectal cancer patients treated with chemotherapy in Alberta (1995-2004)
Survival of metastatic colorectal cancer patients treated with chemotherapy in Alberta (1995-2004)
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DOI：
10.1007/s00520-009-0647-x
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发表时间：
2010-02-01
影响因子：
3.1
通讯作者：
Bryant, Heather E.
中科院分区：
文献类型：
--
作者：
Chen, Yiqun;Qiu, Zhenguo;Bryant, Heather E.
临床试验表明，化疗的进步显著提高了转移性结直肠癌患者的存活率。来自临床实践的可比证据很少。本研究旨在调查加拿大艾伯塔省接受化疗的转移性结直肠癌患者的存活率。使用艾伯塔省癌症登记中心(ACR)的数据评估1994-2003年确诊患者的相对存活率趋势。2004年确诊的患者的中位总存活率(OS)是通过将癌症登记数据与电子医疗记录(EMR)联系起来确定的。COX回归模型用于计算接受化疗的转移性结直肠癌患者的风险比。在这10年(1994年至2003年，p<；0.015)中，接受化疗的转移性结直肠癌患者的2年相对生存率从29%显著增加到41%。在调整了年龄、性别和转移数量后，168名接受化疗的患者与87名未接受化疗的患者相比，死亡风险降低了69%。接受化疗的患者中位OS为17.5个月。这与最近发表的临床试验中看到的18-20个月的情况相当，考虑到这项研究中的患者来自真实的临床实践，其中近一半的人年龄超过70岁，其中许多人可能有重要的合并症。近年来，艾伯塔省被诊断为转移性结直肠癌的患者的存活率有所提高；这很可能在很大程度上归因于化疗的使用。
Clinical trials have suggested that advances in chemotherapy significantly improve the survival of patients with metastatic colorectal cancer. Comparable evidence from clinical practice is scarce. This study aims to investigate the survival of patients with metastatic colorectal cancer treated with chemotherapy in Alberta, Canada.Trends of relative survival of patients diagnosed in 1994-2003 were assessed using Alberta Cancer Registry (ACR) data. The median overall survival (OS) of patients diagnosed in 2004 was determined by linking Cancer Registry data with Electronic Medical Records (EMR). Cox regression models were fitted to calculate the hazard ratio for patients treated with chemotherapy.The 2-year relative survival for patients with metastatic colorectal cancer who received chemotherapy increased significantly from 29% to 41% over the 10 years (1994-2003, p < 0.015). A 69% reduction in the risk of mortality was observed in the 168 patients who received chemotherapy compared to the 87 patients who did not, after adjusting for age, gender, and number of metastases. The median OS of patients who received chemotherapy was 17.5 months. This is comparable to the 18-20 months seen in recently published clinical trials, considering the patients in this study were from the real clinical practice, nearly half of them were older than 70, and many of them might have important co-morbidities.The survival of patients diagnosed with metastatic colorectal cancer in Alberta has improved in recent years; this is most likely attributable in large part to the use of chemotherapy.