Survival benefit in colorectal cancer – an analysis of a population-based clinical cancer registry

A. Schlesinger-Raab, R. Eckel, G. Schubert-Fritschle, D. Hölzel, J. Engel
Munich Cancer Registry (MCR) of the Munich Cancer Centre (MCC)

Objective

The study aim was to evaluate improvement in survival of colorectal cancer over a time period of 20 years.

Methods

About 41,000 patients’ diagnoses with colorectal cancer between 1990 and 2010 in the catchment area of the Munich Cancer Registry (population 4.6 million) were evaluated.
Distributions of patient and tumour characteristics as well as overall (OS) and relative survival (RS) were analysed in regard to time period of initial diagnosis.

Results

Demographic ageing were observed over time with an average increase of age at diagnosis of about three years and an increase in the proportion of patients =70 and =80 years (e.g. =80 years from 18 to 26% in colon and from 11 to 18% in rectal cancer). These older cohorts had a worse prognosis.
The 5-year RS for colon cancer remained stable over time (from 65.9 to 66.6%) and only minor differences were observed for rectal cancer (from 62.7 to 64.3%).
However, after stratification by age, metastases at diagnosis, and UICC stage, benefits could be seen clearly in patients < 70 with initial diagnosis of M0 (5-year RS increased from 80.9 to 87.4% for colon and from 75.3 to 84.6% for rectal cancer) as well as in patients with UICC stage III in colon cancer (from 58.3 to 72.9%) and UICC stages II and III in rectal cancer (stage II from 78.6 to 83.7%, stage III from 51.3 to 71.4%).
Survival improvement for patients with M1 at diagnosis was lower and only observed for patients < 70 years of age.

Conclusion

Survival benefits are superposed by the effect of demographic ageing. In colon cancer, especially for patients < 70 years with M0 at diagnosis or UICC stage III, and in rectal cancer particularly in patients < 70 years with M0 at diagnosis and UICC stage II/III experience survival improvements were observed.

31. Deutscher Krebskongress, Berlin, 19.-22.2.2014.
Oncology Research and Treatment 2014;37 (suppl.1): 45