Improvement of Survival over Time for Colorectal Cancer Patients: A Population-Based Study

Abstract

Purpose: In this study, we analyzed the mortality and survival of colorectal cancer patients in Lithuania. Methods: This was a national cohort study. Population-based data from the Lithuanian Cancer Registry and period analyses were collected. Overall, 20,980 colorectal cancer patients were included. We examined the changes in colorectal cancer mortality and survival rates between 1998 and 2012 according to cancer anatomical sub-sites and stages. We calculated the 5-year relative survival estimates using period analysis. Results: Overall, 20,980 colorectal cancer cases reported from 1998 to 2012 were included in the study. The total number of newly diagnosed colorectal cancers increased from 1998–2002 to 2008–2012 by 12.1%. The highest number of colorectal cancers was localized and increased from 33.9% to 42.0%. The number of cancers with regional metastases and advanced cancers decreased by 11.1% and 15.5%, respectively. An increased number of new cases was observed for almost all colon cancer sub-sites. The overall 5-year relative survival rate increased from 37.9% in 1998–2002 to 51.5% in 2008–2012. We showed an increase in survival rates for all stages and all sub-sites. In the most recent period, patients with a localized disease had a 5-year survival rate of 78.6%, while survival estimates for advanced cancer patients remained low at 6.6%. Conclusion: Although survival rates variated in colorectal cancer patients according to disease stages and sub-sites, we showed increased survival rates for all patients.

Linear Tumor Regression of Rectal Cancer in Daily MRI during Preoperative Chemoradiotherapy: An Insight of Tumor Regression Velocity for Personalized Cancer Therapy

“…The advancement in treatment strategies has been remarkable in the field of rectal cancer, establishing neoadjuvant concurrent chemoradiotherapy (CCRT) as the current standards of care for the locally advanced disease [ 3 , 4 , 5 , 6 , 7 ]. The advances are still in progress and have developed in both ways: treatment intensification, such as total neoadjuvant therapy, and treatment de-intensification, such as the watch-and-wait approach [ 8 , 9 ].…”

Improvement in colorectal cancer outcomes over time is limited to patients with left-sided disease

“…This might explain to some extent why not all of the published results are conclusive. For example, in one study the relative increase in clinical bene t from 1998-2008 compared to 2008-2012 was 11% less for LCRC than for RCC (Dulskas et al 2020). This length bias can be avoided by using mortality rates rather than survival times or survival rates (Welch et al 2000; Gigerenzer and Wegwarth 2013).…”

“…However, the mortality rate for disseminated RCC has not changed to the same extent as the respective incidence rate. This might re ect the reduced bene t that RCC gains from oncological treatment based on the biological differences between RCC and LCRC, especially, if the RAS-mutation status is considered in oncological treatment decisions (Benedix et In published observations reporting on differences in the clinical outcome in LCRC and RCC the relative 5year survival rates are applied for comparing oncological outcome between distinct time intervals (Brouwer et al 2018;Dulskas et al 2020). The risk of a lead-time bias in such approaches is problematic, especially in CRC, which is a screening sensitive disease.…”

Hand Assisted Laparoscopic Surgery for Colorectal Cancer: Surgical and Oncological Outcomes from a Single Tertiary Referral Centre

“…It should be brought to attention that in this unselected patient population excellent 5-year overall survival and disease-free survival results were achieved, both as such, and especially comparing to Lithuanian result in general. There are very few studies regarding survival of colorectal cancer patients in Lithuania related to the period of our study [28][29][30].…”