Survival for colon and rectal cancer in Estonia: Role of staging and treatment
Survival for colon and rectal cancer in Estonia: Role of staging and treatment
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DOI：
10.3109/0284186x.2011.633928
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发表时间：
2012-04-01
期刊：
影响因子：
3.1
通讯作者：
Aareleid, Tiiu
中科院分区：
文献类型：
--
作者：
Innos, Kaire;Soplepmann, Jaan;Aareleid, Tiiu
背景资料。国际比较表明，与其他欧洲国家相比，爱沙尼亚的结直肠癌(CRC)存活率较低。本文的目的是分析爱沙尼亚结直肠癌的长期存活率以及分期和治疗模式。材料和方法。分析包括爱沙尼亚1997年诊断的所有儿童疾病病例(n=546)，这些病例是通过爱沙尼亚癌症登记处查明的，并在确诊后进行了10年的跟踪调查。分期和治疗数据是从病历中回溯收集的。用相对存活率(RSR)评估预后。结果与结论。结肠癌和直肠癌的5年RSR分别为51%和38%；10年RSR分别为50%和39%。我们没有观察到早期疾病的额外死亡率。对于II期和III期，结肠癌(5年RSR分别为79%和66%)明显高于直肠癌(分别为66%和30%)。约30%的病例被诊断为远处疾病。在根治性手术的结肠癌和直肠癌患者中，10年RSR分别为90%和70%。大多数有可用的病理信息的患者都检查了一到四个淋巴结。在爱沙尼亚，结肠癌的存活率显著提高，但直肠癌的存活率却没有明显提高。首次诊断时有远处转移的患者比例高，分期不充分，接受治疗性手术和适当的化疗和放射治疗的患者比例较低，可能是导致这一结果的原因之一。通过早期诊断和实施更高的分期和治疗标准，可以取得进展。这些结论可能也适用于其他东欧国家。
Background. International comparisons have indicated low colorectal cancer (CRC) survival in Estonia, compared to other European countries. The objective of this paper is to analyse long-term survival as well as staging and treatment patterns of CRC in Estonia. Material and methods. The analysis included all incident cases of CRC diagnosed in Estonia in 1997 (n = 546), identified through the Estonian Cancer Registry and followed up for 10 years after diagnosis. Staging and treatment data were retrospectively collected from medical records. Relative survival rate (RSR) was used to estimate the outcome. Results and conclusion. The 5-year RSR was 51% for colon cancer and 38% for rectal cancer; the corresponding 10-year RSR was 50% and 39%. We observed no excess mortality for early disease. For stages II and III, the survival was markedly higher in colon cancer (5-year RSR 79% and 66%, respectively) compared to rectal cancer (66% and 30%, respectively). Around 30% of cases were diagnosed with distant disease. Among radically operated colon and rectal cancer patients, the 10-year RSR was 90% and 70%, respectively. Most patients with available pathological information had one to four lymph nodes examined. Survival has notably improved for colon cancer, but not for rectal cancer in Estonia. High proportion of cases with distant metastasis at first diagnosis along with inadequate staging and low proportion of patients treated with curatively intended surgery and appropriate chemotherapy and radiotherapy may have contributed to this outcome. Progress could be achieved by earlier diagnosis and implementing higher standards for staging and treatment. These conclusions are likely to be relevant also for other Eastern European countries.