Impact of age and comorbidity on survival in colorectal cancer
- PMID: 26697191
- PMCID: PMC4671847
- DOI: 10.3978/j.issn.2078-6891.2015.070
Impact of age and comorbidity on survival in colorectal cancer
Abstract
Background: Patients with colorectal cancer are often excluded from clinical trials based on age or a poor performance score. However, 70% of colorectal cancer is diagnosed in patients over 65. Evaluation on the influence of age and comorbidity on survival and cause of death in a non-selected population.
Methods: Included were 621 consecutive patients with colorectal cancer. An extensive chart review was performed for 392 patients with colon cancer and 143 patients with rectal cancer. Analyses were performed separately for both groups.
Results: Median survival of colon cancer patients was 5.13 years, 131 patients (34.3%) died from tumour progression. Age and comorbidity were significant predictors for overall survival (P<0.001). Age was also a significant predictor of cause of death (P=0.001). In rectal cancer patients median survival was 4.67 years, 51 (35.7%) of patients died from tumour progression. Neither age nor comorbidity was significant predictors of survival. Age was a significant predictor of cause of death (P<0.001).
Conclusions: In colon cancer patient age and comorbidity predict survival. This represents possible bias or a reduced survival benefit of treatment, and is an indication that colon cancer is not the prognosis defining illness in the majority of patients. In rectal cancer patients neither age or comorbidity significantly impacted survival.
Keywords: Charlson score; Colorectal cancer; co-morbidity; epidemiology; survival.
Conflict of interest statement
Figures
Similar articles
-
Aspects of survival from colorectal cancer in Denmark.Dan Med J. 2012 Apr;59(4):B4428. Dan Med J. 2012. PMID: 22459726
-
Comorbidity and survival of Danish patients with colon and rectal cancer from 2000-2011: a population-based cohort study.Clin Epidemiol. 2013 Nov 1;5(Suppl 1):65-74. doi: 10.2147/CLEP.S47154. eCollection 2013. Clin Epidemiol. 2013. PMID: 24227924 Free PMC article.
-
Influence of age and comorbidity on prognosis and application of adjuvant chemotherapy in elderly Japanese patients with colorectal cancer: A retrospective multicentre study.Eur J Cancer. 2017 Aug;81:90-101. doi: 10.1016/j.ejca.2017.05.024. Epub 2017 Jun 13. Eur J Cancer. 2017. PMID: 28622612
-
Survival of elderly persons undergoing colonoscopy: implications for colorectal cancer screening and surveillance.Gastrointest Endosc. 2007 Sep;66(3):544-50. doi: 10.1016/j.gie.2007.01.008. Gastrointest Endosc. 2007. PMID: 17725944
-
[The efficacy of the multidisciplinary approach in colorectal cancer surgery in elderly patients].Khirurgiia (Mosk). 2012;(2):4-13. Khirurgiia (Mosk). 2012. PMID: 22678468 Review. Russian.
Cited by
-
Patient-reported outcomes as predictors of survival in patients with bowel cancer: a systematic review.Qual Life Res. 2019 Nov;28(11):2871-2887. doi: 10.1007/s11136-019-02255-0. Epub 2019 Jul 30. Qual Life Res. 2019. PMID: 31364037
-
Clinicopathological, genomic and immunological factors in colorectal cancer prognosis.Br J Surg. 2018 Jan;105(2):e99-e109. doi: 10.1002/bjs.10756. Br J Surg. 2018. PMID: 29341159 Free PMC article. Review.
-
A comparison of frailty measures in population-based data for patients with colorectal cancer.Age Ageing. 2024 May 1;53(5):afae105. doi: 10.1093/ageing/afae105. Age Ageing. 2024. PMID: 38783754 Free PMC article.
-
Impact of Age and Comorbidity on Multimodal Management and Survival from Colorectal Cancer: A Population-Based Study.J Clin Med. 2021 Apr 17;10(8):1751. doi: 10.3390/jcm10081751. J Clin Med. 2021. PMID: 33920665 Free PMC article.
-
A Survival Analysis of Gastric or Colorectal Cancer Patients Treated With Surgery: Comparison of Capital and a Non-capital City.J Prev Med Public Health. 2017 Sep;50(5):283-293. doi: 10.3961/jpmph.17.043. J Prev Med Public Health. 2017. PMID: 29020762 Free PMC article.
References
-
- Integraal kanker centrum Nederland, 2014. Accessed December, 2014. Available online: www.cijfersoverkanker.nl
-
- Townsley CA, Selby R, Siu LL. Systematic review of barriers to the recruitment of older patients with cancer onto clinical trials. J Clin Oncol 2005;23:3112-24. - PubMed
-
- Trimble EL, Carter CL, Cain D, et al. Representation of older patients in cancer treatment trials. Cancer 1994;74:2208-14. - PubMed
-
- Murthy VH, Krumholz HM, Gross CP. Participation in cancer clinical trials: race-, sex-, and age-based disparities. JAMA 2004;291:2720-6. - PubMed
-
- Dutch guideline for the diagnosis and treatment of colorectal cancer, 2014. Accessed December, 2014. Available online: www.oncoline.org
LinkOut - more resources
Full Text Sources