Publication
Baseline mortality-adjusted survival in resected rectal cancer patients
Journal Paper/Review - Aug 5, 2014
Tarantino Ignazio, Mueller Sascha, Warschkow Rene, Kulu Yakup, Schmied Bruno, Büchler Markus W, Ulrich Alexis
Units
PubMed
Doi
Contact
Citation
Type
Journal
Publication Date
Issn Electronic
Pages
Brief description/objective
BACKGROUND
This investigation assessed the baseline mortality-adjusted 5-year survival after open rectal cancer resection.
METHODS
The 5-year survival rate was analyzed in 885 consecutive American Joint Committee on Cancer (AJCC) stage I-IV rectal cancer patients undergoing open resection between 2002 and 2011 using risk-adjusted Cox proportional hazards regression models adjusted for population-based baseline mortality.
RESULTS
The 5-year relative and overall survival rates were 80.9 %(95 % confidence interval (CI): 77.0-85.0 %) and 71.9 %(95 % CI, 68.4-75.5 %), respectively. The 5-year relative survival rates for stage I, II, III, and IV cancer were 97.8 % (95 % CI, 93.1-102.8 %), 90.9 %(95 % CI, 84.3-98.1 %), 72.0 % (95 % CI, 64.7-80.1 %), and 24.4 % (95 % CI: 16.0-37.0 %), respectively. After the curative resection of stage I-III rectal cancer, fewer than every other observed death was cancer-related. The 5-year relative survival rate for stage I cancer did not differ from the matched average national baseline mortality rate (P = 0.419). Higher age (hazard ratio (HR) 0.94, 95 % CI: 0.92-0.95, P < 0.001) was protective for relative survival but unfavorable for overall survival (HR 1.04, 95 % CI: 1.02-1.05, P < 0.001). Female gender was only unfavorable for relative survival (HR 1.59, 95 % CI: 1.11-2.29, P = 0.014).
CONCLUSION
The analysis of relative survival in a large cohort of rectal cancer patients revealed that stage I rectal cancer is fully curable. The findings regarding age and gender may explain the conflicting results obtained to date from studies based on overall survival.