Hospital-based colorectal cancer survival trend of different tumor locations from 1960s to 2000s.
Hospital-based colorectal cancer survival trend of different tumor locations from 1960s to 2000s.
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DOI：
10.1371/journal.pone.0073528
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Wan DS
中科院分区：
文献类型：
--
作者：
Fang YJ;Wu XJ;Zhao Q;Li LR;Lu ZH;Ding PR;Zhang RX;Kong LH;Wang FL;Lin JZ;Chen G;Pan ZZ;Wan DS
我们的目的是探讨结直肠癌（CRC）的生存率与1960年至2000年登记的患者的不同临床特征之间的关系。我们假设结直肠癌的存活率随时间而增加，并根据解剖部位而变化。分析了1960年代至2008年登记的总计4558例T（1-4）N（1-2）M0期CRC患者的信息。分析年龄、性别、肿瘤部位、时间、组织病理学类型、病理分级、淋巴结检查数、T分期和N分期与结直肠癌总生存率的关系。使用考克斯比例风险回归模型评估预后因素对患者生存率的影响。从1960年到2008年，研究的CRC患者分别包括2625例（57.6%）和1933例（42.4%）男性和女性。其中包括1896例（41.6%）结肠癌和2662例（58.4%）直肠癌。20世纪60年代、70年代、80年代、90年代和2000年代的5年生存率分别为49%、58%、58%、70%和77%。结肠癌和直肠癌患者的5年生存率明显提高。60岁以上的患者更容易患结肠癌（乙状结肠）而不是直肠癌（49.2% vs. 39.9%）。考克斯回归模型显示，只有直肠癌的生存率与时间有关。总体生存率和5年生存率从1960年代到2000年代有所增加。结直肠癌患者的肿瘤部位有明显移位的趋势。
Our aim is to explore the trend of association between the survival rates of colorectal cancer (CRC) and the different clinical characteristics in patients registered from 1960s to 2000s. We hypothesized that the survival rate of CRC increases over time and varies according to anatomic subsites. Information from a total of 4558 stage T(1-4)N(1-2)M0 CRC patients registered from 1960s to 2008 were analyzed. The association of CRC overall survival with age, gender, tumor locations, time, histopathology types, pathology grades, no. of examined lymph nodes, the T stage, and the N stage was analyzed. The assessment of the influence of prognostic factors on patient survival was performed using Cox’s proportional hazard regression models. From 1960 to 2008, the studied CRC patients included 2625 (57.6%) and 1933 (42.4%) males and females, respectively. These included 1896 (41.6%) colon cancers, and 2662 (58.4%) rectum cancers. The 5-year survival rate was 49%, 58%, 58%, 70%, and 77% for the time duration of 1960s, 1970s, 1980s, 1990s and 2000s, respectively. An increased 5-year survival rate was observed in the colon cancer and rectum cancer patients. Patients older than 60 years of age were more likely to develop colonic cancer (sigmoid) than rectum cancer (49.2% vs. 39.9%). The Cox regression model showed that only rectum cancer survival was related to time duration. The overall survival and 5-year survival rates showed an increase from the 1960s to 2000s. There is a trend of rightward shift of tumor location in CRC patients.
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