Gender differences in outcomes for early-stage colon cancer.

Abstract

605 Background: Retrospective analyses of clinical trials suggest that gender may influence the risk of recurrence and survival in patients diagnosed with early stage colon cancer. Whether this association persists in the setting of routine clinical practice is unclear. Our aims were to 1) assess for gender differences in outcomes in early stage colon cancer and 2) evaluate if the effect of gender on outcomes is modified by adjuvant therapy (AT). Methods: Using a population-based cohort of patients diagnosed with stage II or III colon cancer and referred to any 1 of 5 regional cancer centers in British Columbia, Canada from 2001 to 2005, we compared 5-year outcomes between men and women. Multivariate Cox proportional hazard models were constructed to explore the relationships between gender and prognosis, while controlling for patient and tumor characteristics. Interaction terms between gender and AT were used to examine the predictive value of gender. Results: We included 1837 patients: 970 men and 867 women. Baseline characteristics were similar: median ages were 68 and 69 years; 39 and 38% had stage II colon cancer; and 46 and 44% received AT, respectively. Outcomes were better in women than in men (5-year cancer-specific survival rate 73 vs. 71% and 5-year overall survival rate 68 vs. 62%). In Cox regression models, women continue to experience better overall prognosis (HR for death = 0.80, 95% CI 0.69-0.92, p=0.003) when compared to men. Advanced age, stage III disease, and lack of AT also correlated with worse outcomes (all p<0.01). The effect of gender on outcomes remained similar regardless of AT (HR 0.86 among women with AT and HR 0.75 among women without AT, interaction p=0.35). Conclusions: Gender is a prognostic, but not a predictive, factor for this cohort of patients with early stage colon cancer. Studies to investigate the biological mechanisms underlying this gender difference in outcomes are warranted.

Colorectal Cancer in India: An Iceberg Analysis From North India

“…Also as discussed earlier there is more incidence of signet and Mucinous carcinoma in younger patients and greater proportion of cases arising in ulcerative colitis comparing sex of the patient with stage of tumor it was seen that the maximum number of males presented with stage III, while stage II was predominant amongst females. Griffin et al and Alipour et al [34,35] studied various predictors of survival in colorectal cancer and evaluated that for a given age and stage, females had better outcome than males which was reflected in our study too.…”

Gender differences in colorectal cancer survival: A meta‐analysis

“…7,[12][13][14][15][16][17][18][19] Pooled analysis of OS showed a significant difference between women and men with slight heterogeneity in a fixed effects model(HR 5 0.87, 95% CI: 0.85-0.89, p < 0.00001; I 2 5 26%, p 5 0.22, Fig. Overall survival (OS) was significantly longer in female patients than male patients with colorectal cancer, as reported in the nine included studies.…”

“…Overall survival (OS) was significantly longer in female patients than male patients with colorectal cancer, as reported in the nine included studies. 7,[12][13][14][15][16][17][18][19] Pooled analysis of OS showed a significant difference between women and men with slight heterogeneity in a fixed effects model(HR 5 0.87, 95% CI: 0.85-0.89, p < 0.00001; I 2 5 26%, p 5 0.22, Fig. 2).…”

Clinicopathological Characteristics and Overall 5-Year Survival of Colorectal Cancer: A Retrospective Study

“…Our analysis showed no significant association between sex and survival; however, conflicting data have been reported in the literature. Some studies reported that the female sex is associated with better survival, while others showed no difference [ 5 , 17 , 18 , 19 ]. Different variables, such as region and limited sample size, can explain this discrepancy.…”