Sixteen Years of Experience with the Treatment of Advanced Colorectal Cancer in Iran; A Report from Three Institutions

Abstract

BACKGROUND Colorectal cancer (CRC) is one of the most common cancers worldwide. Recently treatments of advanced CRC have been immensely improved. In this study we reported the current state of advanced CRC in Iran regarding treatment and outcomes from 2000 to 2016. METHODS 370 subjects with stage III or IV of the disease were included in this study. Pathological subtypes other than adenocarcinoma were excluded. Demographics and other relevant clinical data were collected. RESULTS Mean age at diagnosis was 55.4 ± 12.6 years. Significant differences regarding the age, sex, primary tumor complication and location, lymph node involvement, and tumor size were not detected between patients with stage III and IV. Overall survival rate at 5 years was 69.5% (95% confidence interval: 60.8% - 76.6%) and 21.73% (95% CI: 12.46% - 32.70%) for patients with stage III and IV, respectively. Analysis of prognostic factors revealed that tumor grade was an independent factor predicting poorer outcome (poorly differentiated vs. well or moderately differentiated). Furthermore, in stage IV of the disease, IVb subgroup was found to be associated with a poorer outcome compared with stage IVa. CONCLUSION Even with the acceptable survival rates and more effective treatments, it seems that clinicopathological characteristics have yet the most important prognostic effect in advanced CRC.

Epidemiological aspects of colorectal cancer in East Azerbaijan, Northwest Iran: five year survival analysis

“…(11) However in another group of studies age was not reported as an important prognostic factor. (30,31) It has been elucidated that age at diagnosis has no impact on colorectal cancer specific survival rates, but has an impact on deaths due to other causes and on hazard ratio of age at first diagnosis of colorectal cancer. (32) However our results in relation to effects of age were similar to those of the latter as there was no significant difference between patients younger than 50 years and older than 50 years of age in terms of mortality hazard.…”

Survival Rate of Colorectal Cancer in Eastern Mediterranean Region Countries: A Systematic Review and Meta-Analysis

“…More specifically, the present review included studies published between 2000 and 2018. Based on geographical location, 29 studies were from Iran, 28 -56 4 study from Saudi Arabia, 57 -60 3 from Oman, 61 -63 2 from Jordan, 64,65 1 from Libya, 66 1 from Kuwait, 67 1 from Lebanon, 68 1 from Pakistan 69 and 1 was from United Arab Emirates. 70 The characteristics of the studies are illustrated in Table 1.…”

Special issue “The advance of solid tumor research in China”: Prognosis prediction for stage II colorectal cancer by fusing computed tomography radiomics and deep‐learning features of primary lesions and peripheral lymph nodes

“…Postoperative adjuvant chemotherapy (ACT) can help eradicate micrometastases and surgical residues to prevent the formation of distant metastases. [2][3][4][5] However, considering the cost, toxicity and limited survival benefits of ACT, whether postoperative ACT should be administered to stage II CRC patients has long been controversial. 6,7 According to international guidelines, ACT is usually recommended for stage II CRC patients with one or more of the following high-risk characteristics: T4 tumors, perforation, obstruction, vascular infiltration, less than 12 lymph nodes (LNs) to be examined and poorly differentiated pathological types.…”

“…Presently, the main treatment for locoregional CRC is complete surgical resection. Postoperative adjuvant chemotherapy (ACT) can help eradicate micrometastases and surgical residues to prevent the formation of distant metastases 2‐5 . However, considering the cost, toxicity and limited survival benefits of ACT, whether postoperative ACT should be administered to stage II CRC patients has long been controversial 6,7 .…”