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. 2021 Nov 17;9(6):571-582.
doi: 10.1093/gastro/goab048. eCollection 2021 Dec.

Clinical characteristics and survival analysis of colorectal cancer in China: a retrospective cohort study with 13,328 patients from southern China

Lekun Fang  1   2   3 , Ziqing Yang  1   2 , Mingliang Zhang  4 , Manqi Meng  1   2 , Junyan Feng  1   2 , Chuangqi Chen  4
Affiliations

Clinical characteristics and survival analysis of colorectal cancer in China: a retrospective cohort study with 13,328 patients from southern China

Lekun Fang et al. Gastroenterol Rep (Oxf). .

Abstract

Background: Colorectal cancer (CRC) is one of the most common cancers in China. However, detailed clinical characteristics and survival information are limited. This study aimed to investigate the potential epidemiological and clinical risk factors affecting the survival of CRC patients in southern China.

Methods: Patients with primary CRC between 1994 and 2019 at the First and the Sixth Affiliated Hospitals of Sun Yat-sen University (Guangzhou, China) were included. Clinical characteristics and survival outcomes were collected from medical records. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS), and Cox's proportional-hazards regression model was used to estimate hazard ratios and 95% confidence intervals.

Results: Of all 13,328 patients, 60.1% were men; the mean age was 61.3 years; 53.5% had colon cancer. Among all patients, 1,864 (14.0%) were diagnosed with stage IV disease. The 3- and 5-year OS rates were 79.90% and 71.50%, respectively, whereas the 3- and 5-year PFS rates were 70.30% and 63.90%, respectively. The median OS and PFS times were 189 and 149 months, respectively. Among 13,328 patients, 428 (14.0%) patients with poor/undifferentiated cancer suffered recurrence. In patients with stage III and stage IV diseases, the median PFS times of the patients who received chemotherapy were significantly longer than those in patients who had not received chemotherapy (stage III: 147 vs 62 months, P < 0.001; stage IV: 14 vs 9.5 months, P < 0.001).

Conclusions: This retrospective cohort study illustrates the current status of the clinical characteristics of patients with CRC in southern China. Sex, age, family history, location of cancer occurrence, differentiation status, T status, N status, M status, clinical stage, operation, and surgical margin are independent factors associated with the OS of CRC patients.

Keywords: clinical characteristics; colorectal cancer; overall survival; progression.

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Figures

Figure 1.
Figure 1.
Kaplan–Meier overall survival curves of the CRC patients. Kaplan–Meier overall survival curves of all of the CRC patients (A) and the patients with several clinical characteristics (B–F), including (B) locations at which cancer occurred, (C) differentiation status, (D) clinical stages, (E) pathological subtypes, (F) chemotherapy, (G) operation, and (H) surgical margin. Log-rank analysis was used to test for significance. MA, mucinous adenocarcinoma; SRCC, signet-ring cell carcinoma.
Figure 2.
Figure 2.
Kaplan–Meier progression-free survival curves of the CRC patients. Kaplan–Meier progression-free survival curves of all of the CRC patients (A) and the patients with several clinical characteristics (B–F), including (B) locations at which cancer occurred, (C) differentiation status, (D) clinical stages, (E) pathological subtypes, (F) chemotherapy, (G) operation, and (H) surgical margin. Log-rank analysis was used to test for significance. MA, mucinous adenocarcinoma; SRCC, signet-ring cell carcinoma.
Figure 3.
Figure 3.
Kaplan–Meier overall survival curves of CRC patients who received chemotherapy or no chemotherapy at different clinical stages. Kaplan–Meier overall survival curves of the CRC patients received chemotherapy or no chemotherapy at different clinical stages, including (A) stage I, (B) stage II, (C) stage III, and (D) stage IV. Log-rank analysis was used to test for significance.
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