A population‐based study elicits a reverse correlation between age and overall survival in elderly patients with rectal carcinoma receiving adjuvant chemotherapy

Shan, Jinlu; He, Zhisong; Ren, Tao; Zhou, Shu‐Feng; Wang, Dong

doi:10.1111/1440-1681.12420

Cited by 6 publications

(5 citation statements)

References 63 publications

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“…The data showed that this kind of treatment improved disease-free and overall survival of patients. In our study, patients with locally advanced cancers who were performed adjuvant chemotherapy had a positive prognosis (MST, 65.0 months; HR, 0.60; P=0.001), this result consistent with our research before [21].…”

Section: Discussionsupporting

confidence: 92%

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The influence of neoadjuvant therapy for the prognosis in patients with rectal carcinoma: a retrospective study

Peng

Wang

et al. 2015

Tumor Biol.

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Rectal cancer, defined as a cancerous lesion of the colon distal to the rectosigmoid junction, is the fourth most common cancer cause of death globally. There were 474 patients with rectal cancer who underwent surgery between October 2007 and May 2013 enrolled in our center. Patients were respectively categorized by neoadjuvant therapy. This study aimed to explore the predictive factors that affected the Progression-free survival and overall survival of the patients with rectal cancer. Clinical characteristics of patients were compared with the groups and potential prognostic factors were analyzed by SPSS 19.0. In our study, neoadjuvant therapy increased the anus-retained rate (64.4 vs 53.4 % P = 0.016) and remission rate in the treatment group, compared to the non-treatment group (62.6 vs 34.8 %; P = 0.000). The neoadjuvant concurrent chemoradiotherapy, more operative duration, anus retained and micturition damaged are positive prognostic factors of PFS to patients. Poor differentiation, the tumor of ulcer, invasive, and pT4 stage, contributed the poor factors for PFS of patients (P< 0.05). Additionally, the patients with neoadjuvant concurrent chemoradiotherapy and adjuvant chemotherapy underwent the better prognosis of OS. Adjuvant chemotherapy cannot increase PFS of the patients who accepted neoadjuvant therapy after surgery get pCR, but can improve OS. The anus-retained and neoadjuvant radiotherapy, duration of surgery in rectal cancer have the positive correlation. Micturition damaged and neoadjuvant radiotherapy were positively correlated as well. In conclusion, adjuvant chemotherapy does not improve the PFS of patients with pCR to neoadjuvant therapy, but is good for OS. Further prospective and large population-based clinical studies are needed to establish clinical guidelines for the use of neoadjuvant therapy and adjuvant chemotherapy in patients with rectal cancer.

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Section: Discussionsupporting

confidence: 92%

“…Our results showed preoperative radiotherapy increased pelvic inflammatory disease and pelvic organ adhesions and then give a risk of pelvic nerve injury. Thus, the complete surgical resection attributes to the patients a good PFS, but not OS [21].…”

Section: Discussionmentioning

confidence: 99%

The influence of neoadjuvant therapy for the prognosis in patients with rectal carcinoma: a retrospective study

Peng

Wang

et al. 2015

Tumor Biol.

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“…As the third most commonly cancer, 135,430 colorectal cancer cases were newly diagnosis and 50,260 patients died of colorectal cancer in 2017 in United States. [1] Researchers have studied some pathological factors such as gene expression [2] and reaction of chemotherapy [3,4] that might affect survival of RC, however, it is possible for sociodemographic factors to affect survival of patients with RC. Marital status is known as one type of social support with beneficial psychological properties.…”

Section: Introductionmentioning

confidence: 99%

Marital status and survival in patients with rectal cancer

Wang

Zhang

et al. 2018

Medicine

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To examine the impact of marital status on overall survival (OS) and rectal cancer-specific survival (RCSS) for aged patients.We used the Surveillance, Epidemiology and End Results database to identify aged patients (>65 years) with early stage rectal cancer (RC) (T1-T4, N0, M0) in the United States from 2004 to 2010. Propensity score matching was conducted to avoid potential confounding factors with ratio at 1:1. We used Kaplan-Meier to compare OS and RCSS between the married patients and the unmarried, respectively. We used cox proportion hazard regressions to obtain hazard rates for OS, and proportional subdistribution hazard model was performed to calculate hazard rates for RCSS.Totally, 5196 patients were included. The married (2598 [50%]) aged patients had better crude 5-year overall survival rate (64.2% vs 57.3%, P < .001) and higher crude 5-year cancer-specific survival rate (80% vs 75.9%, P < .001) than the unmarried (2598 (50%)), respectively. In multivariate analyses, married patients had significantly lower overall death than unmarried patients (HR = 0.77, 95% CI = 0.71-0.83, P < .001), while aged married patients had no cancer-specific survival benefit versus the unmarried aged patients (HR = 0.92, 95% CI = 0.81-1.04, P = .17).Among old population, married patients with early stage RC had better OS than the unmarried, while current evidence showed that marital status might have no protective effect on cancer-specific survival.

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“…The degree of tumour differentiation has an impact on OS and CSS, that is, the higher the grade of the tumour is, the worse the prognosis of the patient, which is not observed in noncancer-related death. In previous studies, it was found that patients with poorly differentiated rectal cancer had a poor prognosis, but in patients treated with chemoradiotherapy, we found that the better the differentiation was, the worse the prognosis was [41]. Unsurprisingly, T staging is an independent prognostic factor of OS, CSS and noncancer-related death.…”

Section: Discussionmentioning

confidence: 58%

A nomogram to predict the prognosis of patients with unresected rectal adenocarcinoma undergoing chemoradiotherapy: a population-based study

Liu¹,

Sun²,

Xiang³

2021

J. Cancer

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Background: Chemotherapy combined with radiotherapy is the main treatment strategy for unresectable rectal cancer. However, the prognostic factors of patients with unresectable rectal cancer treated with radiotherapy and chemotherapy have not been systematically studied. Therefore, this study investigated the prognostic factors and prognosis based on surveillance, epidemiology and final results of the SEER medical insurance database. Methods: Primary rectum patients were selected from the SEER database. The independent prognostic factors associated with overall survival (OS), cancer-specific survival (CSS) and noncancer-related death were evaluated using the Kaplan-Meier method and log-rank test, a competing risk model, and the Cox proportional hazards regression model. Two nomograms were established for predicting the 1-and 3-year OS and CSS of patients.Results: A total of 3,998 rectal adenocarcinoma cancer patients who received chemoradiotherapy but had not undergone surgery were included in this study and divided into training (n = 3559) and validation cohorts (n = 439). Patients in the training cohort had a 1-year OS rate of 65.7±0.8%, a 3-year OS rate of 26.6±0.8%, a 5-year OS rate of 1.6±0.8%, and a median survival rate of 20.0 months (range, 19.22-20.8 months). The following factors were significant prognostic factors of OS: age (p< 0.001); tumour grade (p< 0.001); T stage (p< 0.001); M stage (p< 0.001); bone metastasis (p<0.001); brain metastases (p<0.001); liver metastases (p<0.001); lung metastases (p<0.001); marital status (p<0.001) and insurance status (p=0.005). Age (p< 0.001), tumour grade (p< 0.001), T stage (p< 0.001), M stage (p< 0.001), bone metastasis (p<0.001), brain metastases (p<0.001), liver metastases (p<0.001), lung metastases (p<0.001) and race (p=0.034) were independent prognostic factors of CSS. Age (p< 0.001), T stage (p< 0.001), N stage (p=0.007), M stage (p<0.001), liver metastases (p<0.001), lung metastases (p<0.001), marital status (p<0.001) and insurance status (p=0.019) were independently associated with noncancer-related death. Conclusion: Age, tumour grade, T and M stage, bone, brain, liver and lung metastases, marital status and insurance status are independent risk factors for the OS of rectal adenocarcinoma patients who have undergone chemoradiotherapy but have not undergone surgery. Age, tumour grade, T stage, M stage, bone, brain, liver, lung metastases and race were independent prognostic factors of CSS. Age, T, N and M stage, liver and lung metastases, marital status and insurance status, were independently associated with noncancer-related death. Interestingly, the earlier the T stage was, the higher the rate of noncancer-related death. Two nomograms were developed to predict OS and CSS, and the C-indexes were 0.6776 and 0.6744, respectively. Rectal cancer screening is strongly recommended for patients under the age of 50.

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A population‐based study elicits a reverse correlation between age and overall survival in elderly patients with rectal carcinoma receiving adjuvant chemotherapy

Cited by 6 publications

References 63 publications

The influence of neoadjuvant therapy for the prognosis in patients with rectal carcinoma: a retrospective study

The influence of neoadjuvant therapy for the prognosis in patients with rectal carcinoma: a retrospective study

Marital status and survival in patients with rectal cancer

A nomogram to predict the prognosis of patients with unresected rectal adenocarcinoma undergoing chemoradiotherapy: a population-based study

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