Survival of colorectal cancer patients in relation to duration of symptoms and other prognostic factors

Abstract

The effect of duration of symptoms and other prognostic factors on survival was studied by interview using a population-based sample of 154 colorectal cancer patients. The authors found that symptom durations of up to approximately one year before diagnosis had no effect on survival. In addition, it was found that the total number of symptoms was a statistically significant predictor of survival, although no single symptom had a significant effect. Stage, sex, and site also were found to be significant predictors of survival, whereas age, socioeconomic status, and other factors were not predictive.

Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care

“…The present study is pioneering in the sense that it challenges the premises of former models. The finding of a U-shaped association between the length of the diagnostic interval and mortality after diagnosis of cancer provides evidence that previous studies may not have represented reality very well; either because they did not allow for a continuous, nonmonotonic effect (Hillon et al , 1985; Porta et al , 1991; Rupassara et al , 2006) or because they introduced bias by adjusting for intermediate variables such as tumour stage (Polissar et al , 1981; Fernandez et al , 2002; Stapley et al , 2006; Terhaar et al , 2010). This is the first study to address these issues while at the same time controlling for confounding factors at first presentation of symptoms in primary care.…”

“…Over the past three decades, the association between time to diagnosis and mortality has been the subject of at least 14 studies based on data from symptomatic colon and/or rectal cancer patients (Irvin and Greaney, 1977; Polissar et al , 1981; Pescatori et al , 1982; Hillon et al , 1985; Goh et al , 1987; Bako et al , 1988; Porta et al , 1991; Auvinen, 1992; Ponz de Leon et al , 1992; Maguire et al , 1994; Fernandez et al , 2002; Rupassara et al , 2006; Stapley et al , 2006; Terhaar et al , 2010). The studies report either no statistically significant association or the waiting time paradox.…”

“…Although early diagnosis of cancer is generally deemed desirable, some clinicians and researchers are sceptic about the benefits of expediting diagnosis for CRC patients (Irvin and Greaney, 1977; Bako et al , 1988; Rupassara et al , 2006). The reasoning is that diagnostic intervals, measured in weeks to months, may be negligible by comparison with the time required for the development of the tumour, measured in years (Polissar et al , 1981; Pescatori et al , 1982; Auvinen, 1992; Iversen et al , 2009; Terhaar et al , 2010). …”

Ressecções eletiva e de urgência para tratamento de neoplasia maligna do cólon em hospital universitário: estudo de 66 casos

“…O sintoma mais frequente entre os pacientes operados na urgência, foi dor abdominal, enquanto entre os pacientes operados eletivamente, predominou a queixa de sangramento. Existem relatos mostrando uma tendência de pior prognóstico para os pacientes com quaisquer sintomas à apresentação, principalmente quando há obstrução e/ou perfuração 4 , o que limita, de forma significativa, o resultado final na grande maioria dos pacientes da presente casuística.…”

“…No mundo, são quase um milhão de novos casos diagnosticados a cada ano, e essa incidência vem aumentando nas últimas décadas 1 . A ressecção cirúrgica é a chave para o tratamento curativo do câncer de cólon, sendo que os resultados finais são extremamente relacionados à extensão da doença na ocasião do diagnóstico [2][3][4] . Em países desenvolvidos, mais de um terço dos pacientes são diagnosticados através de testes de screening populacionais.…”