Association of age and cause-special mortality in patients with stage I/ II colon cancer: A population-based competing risk analysis

Abstract

This study aimed to determine the probability and prognostic factors of colon cancer-specific mortality (CCSM) and noncancer-specific mortality (NCSM) for patients with stage I/II colon cancer and evaluate the association of age on cause-specific mortality. Materials and methods From Surveillance, Epidemiology, and End Results (SEER) database, we identified 33152 patients with stage I/II colon cancer undergoing surgery between 2004 and 2011. The cumulative incidence of CCSM and NCSM was calculated, and competing risk analysis was performed to investigate prognostic factors for cause-specific mortality. Results In patients <50, 50-75, and >75 years of age, 5-year cumulative incidence of CCSM was 5.7%, 7.8%, and 16.1%, respectively (overall, 10.6%); 5-year cumulative incidence of NCSM was 2.2%, 7.1%, and 26.9%, respectively (overall, 13.8%). The probability of CCSM and NCSM increased with advanced age. The 5-year cumulative incidence of CCSM was higher than NCSM in patients <50 years of age, whereas lower in patients >75 years of age. The probability of CCSM and NCSM was similar in patients 50-75 years of age. Competing-risk multivariable analysis demonstrated that increasing age was a strong predictor of CCSM (per year increase, SHR 1.03,95% confidence interval [CI]: 1.03-1.04). Age was most predictive of NCSM: (per year increase, SHR 1.08, 95% CI: 1.08-1.08). Conclusion Age was significantly associated with an increased cumulative incidence of CCSM and NCSM of patients with stage I/II colon cancer underwent surgery. NCSM was a significant competing event and should be adequately considered when performing survival analysis.

The psoas muscle density as a predictor of postoperative complications in elderly patients undergoing rectal cancer resection

“…Increasing age is considered a decisive risk factor in association with concomitant diseases [40]. It may induce poorer surgical outcomes [41,42]. Portale et al [43] demonstrated that higher CCI was an independent predictor of short-term results of patients who underwent laparoscopic curative resection for rectal cancer, in line with our study.…”

Relative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US

“…Estimating the relative risk of cancer-specific vs noncancer-specific mortality among long-term survivors of cancer is a critical first step in the development of risk-stratified models of care. Although many studies have previously examined competing oncologic vs nononcologic risks of common cancers, [16][17][18][19][20][21][22][23][24]29,38 to our knowledge, this study is the first to focus on long-term (Ն5 years) survivors.…”

“…15 Population-level studies have considered competing risks of cancer vs noncancer mortality in breast, prostate, and colorectal cancers [16][17][18][19][20] and have helped provide insights into the relative association of each with mortality, but they have not focused on long-term (Ն5 years) survivors of definitively treated disease. [21][22][23][24] Longterm survivors should be studied to help inform the management of patients under surveillance by their oncologist who reach the 5-year mark and require pragmatic risk assessment in the upcoming years.…”

“…These models emphasize coordination between oncologists and PCPs while accommodating the unique oncologic and nononcologic health needs of survivors of cancer and have the potential to dramatically reduce large-scale inefficiencies in care while improving the quality of care . Population-level studies have considered competing risks of cancer vs noncancer mortality in breast, prostate, and colorectal cancers and have helped provide insights into the relative association of each with mortality, but they have not focused on long-term (≥5 years) survivors of definitively treated disease . Long-term survivors should be studied to help inform the management of patients under surveillance by their oncologist who reach the 5-year mark and require pragmatic risk assessment in the upcoming years.…”