Clinical characteristics and survival of colorectal cancer patients in Korea stratified by age
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Background/Aims: This nationwide study was undertaken to determine differences in clinicopathologic characteristics and survival of patients with colorectal cancer (CRC) according to age using big data from the Korean National Health Insurance Service (NHIS). Methods: The NHIS data including quality assessment of CRC by the Health Insurance Review & Assessment Service in Korea between 2011 and 2014 were analyzed. Based on age, patients were divided into three groups: not-old patients (< 65), young-old patients (65 to 74 years old) and old-old patients (≥ 75 years old). Results: We included 71,513 CRC patients. The median follow-up duration was 3.2 years (range, 0.003 to 5.5). Male patients constituted 60%. The median age of patients was 65 years (range, 18 to 102). Colon was the cancer site in 59.8% of not-old patients, 62.9% of young-old patients, and 66.1% of old-old patients. Compared to not-old patients, young-old and old-old patients were more likely to be diagnosed with colon adenocarcinoma and well/moderate differentiation or adequate differentiation (all p < 0.001). Old patients underwent more emergency operation (p < 0.001) and received less adjuvant therapy in stage I–III (p < 0.001). The probability of 3-year survival of young-old or old-old patients was worse than that for not-old patients (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.46 to 1.64) (HR, 3.19; 95% CI, 3.03 to 3.37). Conclusions: Old patients with CRC show different histology from younger patients. They are more frequently to have colon as primary lesion. They undergo less adjuvant therapy. Further studies and evidence-based guidelines for older patients with CRC are warranted to improve their outcome.
Abstract
Background/Aims: This nationwide study was undertaken to determine differences in clinicopathologic characteristics and survival of patients with colorectal cancer (CRC) according to age using big data from the Korean National Health Insurance Service (NHIS). Methods: The NHIS data including quality assessment of CRC by the Health Insurance Review & Assessment Service in Korea between 2011 and 2014 were analyzed. Based on age, patients were divided into three groups: not-old patients (< 65), young-old patients (65 to 74 years old) and old-old patients (≥ 75 years old). Results: We included 71,513 CRC patients. The median follow-up duration was 3.2 years (range, 0.003 to 5.5). Male patients constituted 60%. The median age of patients was 65 years (range, 18 to 102). Colon was the cancer site in 59.8% of not-old patients, 62.9% of young-old patients, and 66.1% of old-old patients. Compared to not-old patients, young-old and old-old patients were more likely to be diagnosed with colon adenocarcinoma and well/moderate differentiation or adequate differentiation (all p < 0.001). Old patients underwent more emergency operation (p < 0.001) and received less adjuvant therapy in stage I–III (p < 0.001). The probability of 3-year survival of young-old or old-old patients was worse than that for not-old patients (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.46 to 1.64) (HR, 3.19; 95% CI, 3.03 to 3.37). Conclusions: Old patients with CRC show different histology from younger patients. They are more frequently to have colon as primary lesion. They undergo less adjuvant therapy. Further studies and evidence-based guidelines for older patients with CRC are warranted to improve their outcome.
참고문헌 (24)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2012", Cancer Research and Treatment, 47(2), pp.127~141 (2015), 대한암학회[DOI]
- Balducci L, "Management of cancer in the elderly", Oncology (Williston Park), 20, pp.135~143 (2006)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2009", Cancer Research and Treatment, 44(1), pp.11~24 (2012), 대한암학회
- 신애선, "Increasing Trend of Colorectal Cancer Incidence in Korea, 1999-2009", Cancer Research and Treatment, 44(4), pp.219~226 (2012), 대한암학회[DOI]
- Seo SI, "Comparison of recurrence patterns between ≤5 years and >5 years after curative operations in colorectal cancer patients", J Surg Oncol, 108, pp.9~13 (2013)
- Talarico L, "Enrollment of elderly patients in clinical trials for cancer drug registration : a 7-year experience by the US Food and Drug Administration", J Clin Oncol, 22, pp.4626~4631 (2004)
- Folprecht G, "Irinotecan", fluorouracil combination in first-line therapy of older and younger patients with metastatic colorectal cancer : combined analysis of 2, 691 patients in randomized controlled trials, 2008, pp.26, 1443~1451
- Goldberg RM, "Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil", leucovorin administered bimonthly in elderly patients with colorectal cancer, 2006, pp.24, 4085~4091
- Siegel R, "Colorectal cancer statistics, 2014", CA Cancer J Clin, 64, pp.104~117 (2014)
- Murphy G, "Sex disparities in colorectal cancer incidence by anatomic subsite, race and age", Int J Cancer, 128, pp.1668~1675 (2011)
- "Definition of an older person. Proposed working definition of an older person in Africa for the MDS Project" (2001)[URL]
- Berretta M, "Colorectal cancer in elderly patients : from best supportive care to cure", Anticancer Agents Med Chem, 13, pp.1332~1343 (2013)
- Bailey CE, "Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010", JAMA Surg, 150, pp.17~22 (2015)
- Itatani Y, "Treatment of elderly patients with colorectal cancer", Biomed Res Int, 2018, pp.2176056~ (2018)
- Siegel RL, "Colorectal cancer statistics, 2017", CA Cancer J Clin, 67, pp.177~193 (2017)
- Anderson JH, "Elective versus emergency surgery for patients with colorectal cancer", Br J Surg, 79, pp.706~709 (1992)
- Sjo OH, "Short term outcome after emergency and elective surgery for colon cancer", Colorectal Dis, 11, pp.733~739 (2009)
- Runkel NS, "Outcome after emergency surgery for cancer of the large intestine", Br J Surg, 78, pp.183~188 (1991)
- Kodeda K, "Population-based data from the Swedish Colon Cancer Registry", Br J Surg, 100, pp.1100~1107 (2013)
- Andre T, "Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial", J Clin Oncol, 27, pp.3109~3116 (2009)
- Scheithauer W, "Oral capecitabine as an alternative to i.v. 5-fluorouracil-based adjuvant therapy for colon cancer: safety results of a randomized, phase III trial", Ann Oncol, 14, pp.1735~1743 (2003)
- Sanoff HK, "Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years", J Clin Oncol, 30, pp.2624~2634 (2012)
- Hurria A, "Developing a cancer-specific geriatric assessment : a feasibility study", Cancer, 104, pp.1998~2005 (2005)
- Hurria A, "Predicting chemotherapy toxicity in older adults with cancer : a prospective multicenter study", J Clin Oncol, 29, pp.3457~3465 (2011)