Preoperative chemoradiotherapy for rectal cancer and impact on outcomes – A population-based study

Åsli, Linn M.; Johannesen, Tom Børge; Myklebust, Tor Åge; Møller, Bjørn; Eriksen, Morten; Guren, Marianne G.

doi:10.1016/j.radonc.2017.04.012

Cited by 24 publications

(13 citation statements)

References 36 publications

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“…Although the data collection protocol specified collection of pre-treatment stage data, stage comparisons (and survival by stage) need to be interpreted with caution and future work should focus on improvements in this area. [45] Routine collection of information on diagnostic procedures performed to define stage, such as pathological examination of lymph nodes or clinical assessment using imaging for distant metastasis should be considered. In collaboration with the Union for International Cancer Control, the International Agency for Research on Cancer has also proposed the utilisation of essential TNM that will facilitate the collection of stage data in population-based cancer registries, improve international stage comparisons, and help to elucidate the causes of international variation in survival [46].…”

Section: Discussionmentioning

confidence: 99%

Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

Araghi

Arnold

Rutherford

et al. 2020

Gut

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ObjectivesAs part of the International Cancer Benchmarking Partnership (ICBP) SURVMARK-2 project, we provide the most recent estimates of colon and rectal cancer survival in seven high-income countries by age and stage at diagnosis.MethodsData from 386 870 patients diagnosed during 2010–2014 from 19 cancer registries in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK) were analysed. 1-year and 5-year net survival from colon and rectal cancer were estimated by stage at diagnosis, age and country,Results(One1-year) and 5-year net survival varied between (77.1% and 87.5%) 59.1% and 70.9% and (84.8% and 90.0%) 61.6% and 70.9% for colon and rectal cancer, respectively. Survival was consistently higher in Australia, Canada and Norway, with smaller proportions of patients with metastatic disease in Canada and Australia. International differences in (1-year) and 5-year survival were most pronounced for regional and distant colon cancer ranging between (86.0% and 94.1%) 62.5% and 77.5% and (40.7% and 56.4%) 8.0% and 17.3%, respectively. Similar patterns were observed for rectal cancer. Stage distribution of colon and rectal cancers by age varied across countries with marked survival differences for patients with metastatic disease and diagnosed at older ages (irrespective of stage).ConclusionsSurvival disparities for colon and rectal cancer across high-income countries are likely explained by earlier diagnosis in some countries and differences in treatment for regional and distant disease, as well as older age at diagnosis. Differences in cancer registration practice and different staging systems across countries may have impacted the comparisons.

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Section: Discussionmentioning

confidence: 99%

Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

Araghi

Arnold

Rutherford

et al. 2020

Gut

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“…Adjuvant chemotherapy is associated with improved outcomes in stage III colon cancer and is used universally, but for stage II colon cancer and rectal cancer (in general) its value and therefore its use have been more variable 48, 49, 50. Neo-adjuvant radiotherapy decreases recurrence rates, but evidence for its effect on survival is conflicting and so use also varies within countries16, 51 and between countries 17 . The use of targeted therapy in combination with chemotherapy might help to make tumours amenable to resection in some patients with metastatic or locally advanced disease, 52 but no survival benefit has been shown for this combination 53 .…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment and survival from colorectal cancer in Denmark, England, Norway, and Sweden: a population-based study

Majano

Girolamo

Rachet

et al. 2019

The Lancet Oncology

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SummaryBackgroundSurvival from colorectal cancer has been shown to be lower in Denmark and England than in comparable high-income countries. We used data from national colorectal cancer registries to assess whether differences in the proportion of patients receiving resectional surgery could contribute to international differences in colorectal cancer survival.MethodsIn this population-based study, we collected data from all patients aged 18–99 years diagnosed with primary, invasive, colorectal adenocarcinoma from Jan 1, 2010, to Dec 31, 2012, in Denmark, England, Norway, and Sweden, from national colorectal cancer registries. We estimated age-standardised net survival using multivariable modelling, and we compared the proportion of patients receiving resectional surgery by stage and age. We used logistic regression to predict the resectional surgery status patients would have had if they had been treated as in the best performing country, given their individual characteristics.FindingsWe extracted registry data for 139 457 adult patients with invasive colorectal adenocarcinoma: 12 958 patients in Denmark, 97 466 in England, 11 450 in Norway, and 17 583 in Sweden. 3-year colon cancer survival was lower in England (63·9%, 95% CI 63·5–64·3) and Denmark (65·7%, 64·7–66·8) than in Norway (69·5%, 68·4–70·5) and Sweden (72·1%, 71·2–73·0). Rectal cancer survival was lower in England (69·7%, 69·1–70·3) than in the other three countries (Denmark 72·5%, 71·1–74·0; Sweden 74·1%, 72·7–75·4; and Norway 75·0%, 73·1–76·8). We found no significant differences in survival for patients with stage I disease in any of the four countries. 3-year survival after stage II or III rectal cancer and stage IV colon cancer was consistently lower in England (stage II rectal cancer 86·4%, 95% CI 85·0–87·6; stage III rectal cancer 75·5%, 74·2–76·7; and stage IV colon cancer 20·5%, 19·9–21·1) than in Norway (94·1%, 91·5–96·0; 83·4%, 80·1–86·1; and 33·0%, 31·0–35·1) and Sweden (92·9%, 90·8–94·6; 80·6%, 78·2–82·7; and 23·7%, 22·0–25·3). 3-year survival after stage II rectal cancer and stage IV colon cancer was also lower in England than in Denmark (stage II rectal cancer 91·2%, 88·8–93·1; and stage IV colon cancer 23·5%, 21·9–25·1). The total proportion of patients treated with resectional surgery ranged from 47 803 (68·4%) of 69 867 patients in England to 9582 (81·3%) of 11 786 in Sweden for colon cancer, and from 16 544 (59·9%) of 27 599 in England to 4106 (70·8%) of 5797 in Sweden for rectal cancer. This range was widest for patients older than 75 years (colon cancer 19 078 [59·7%] of 31 946 patients in England to 4429 [80·9%] of 5474 in Sweden; rectal cancer 4663 [45·7%] of 10 195 in England to 1342 [61·9%] of 2169 in Sweden), and the proportion of patients treated with resectional surgery was consistently lowest in England. The age gradient of the decline in the proportion of patients treated with resectional surgery was steeper in England than in the other three countries in all stage categories. In the hypothetical scenario where all patient...

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“…23,24 A recent registry study of patients with rectal cancer stage I–III has shown that preoperative radiotherapy or chemoradiotherapy is associated with reduced risk of local recurrence, and tendency of improved survival, significant in patients >70 years. 25 An explanation for the lower use of radiotherapy might be that a higher risk of recurrence may be deemed acceptable in elderly patients, as in this group maintaining health and function is of great importance in order to maintain ability of self-care. 26 On the other hand, radiation therapy alone, for instance in combination with endorectal brachytherapy, might be an option for achieving local control, as recently explored in the HERBERT study in elderly or inoperable rectal cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment and survival of rectal cancer patients over the age of 80 years: a EURECCA international comparison

et al. 2018

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Preoperative chemoradiotherapy for rectal cancer and impact on outcomes – A population-based study

Cited by 24 publications

References 36 publications

Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

Surgical treatment and survival from colorectal cancer in Denmark, England, Norway, and Sweden: a population-based study

Treatment and survival of rectal cancer patients over the age of 80 years: a EURECCA international comparison

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