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Article

Characteristics Affecting Survival after Locally Advanced Colorectal Cancer in Quebec

1
Institut national de santé publique du Québec, Quebec City, QC, Canada
2
Département de santé publique et médecine préventive, chu de Québec–Université Laval, Quebec City, QC, Canada
3
Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec City, QC, Canada
4
Centre de recherche du chu de Québec–Université Laval, Centre hospitalier universitaire de Québec, Quebec City, QC, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2015, 22(6), 485-492; https://doi.org/10.3747/co.22.2692
Submission received: 2 September 2015 / Revised: 7 October 2015 / Accepted: 2 November 2015 / Published: 1 December 2015

Abstract

Background: We estimated the relations of sociodemographic, organizational, disease, and treatment variables with the risk of death from colorectal cancer (CRC) in a Quebec population-based sample of patients with locally advanced CRC (LACRC) who underwent tumour resection with curative intent. Methods: Information from medical records and administrative databases was obtained for a random sample of 633 patients surgically treated for stages IIIII rectal and stage III colon cancer and declared to the Quebec cancer registry in 1998 and 2003. We measured personal, disease, and clinical management characteristics, relative survival, and through multivariate modelling, relative excess rate (RER) of death. Results: The relative 5- and 10-year survivals in this cohort were 67.7% [95% confidence interval (CI): 65.8% to 69.6%] and 61.2% (95% CI: 58.3% to 64.0%) respectively. Stage T4, stage N2, and emergency rather than elective surgery affected 18%, 24% and 10% of patients respectively. Those disease progression characteristics each independently increased the rer of death by factors of 2 to almost 5. Grade, vascular invasion, and tumour location were also significantly associated with the rer for death. Receiving guideline-adherent treatment was associated with a 60% reduction in the rer for death (0.41; 95% CI: 0.28 to 0.61), an effect that was consistent across age groups. Clear margins (proximal–distal, radial) and clinical trial enrolment were each associated with a nonsignificant 50% reduction in the rer. Of patients less than 70 years of age and 70 years of age and older, 81.3% and 42.0% respectively received guideline-adherent treatment. Conclusions: This study is the first Quebec population-based examination of patients with lacrc and their management, outcomes, and outcome determinants. The results can help in planning CRC control strategies at a population level.
Keywords: colorectal neoplasms; population-based studies; multivariate analyses; relative survival; relative excess hazard rate for death; treatment outcomes; medical records; registries colorectal neoplasms; population-based studies; multivariate analyses; relative survival; relative excess hazard rate for death; treatment outcomes; medical records; registries

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MDPI and ACS Style

Perron, L.; Daigle, J.M.; Vandal, N.; Guertin, M.H.; Brisson, J. Characteristics Affecting Survival after Locally Advanced Colorectal Cancer in Quebec. Curr. Oncol. 2015, 22, 485-492. https://doi.org/10.3747/co.22.2692

AMA Style

Perron L, Daigle JM, Vandal N, Guertin MH, Brisson J. Characteristics Affecting Survival after Locally Advanced Colorectal Cancer in Quebec. Current Oncology. 2015; 22(6):485-492. https://doi.org/10.3747/co.22.2692

Chicago/Turabian Style

Perron, L., J.M. Daigle, N. Vandal, M.H. Guertin, and J. Brisson. 2015. "Characteristics Affecting Survival after Locally Advanced Colorectal Cancer in Quebec" Current Oncology 22, no. 6: 485-492. https://doi.org/10.3747/co.22.2692

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