01.12.2017 | Research article | Ausgabe 1/2017 Open Access

Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Background
Methods
Results
Patients’ characteristics, follow-up and relative survival rates
Characteristics
|
n
|
%
|
|
---|---|---|---|
Sex
|
Male
|
668
|
55.1
|
Female
|
544
|
44.9
|
|
Ethnic groups
|
Chinese
|
808
|
66.7
|
Malays
|
225
|
18.6
|
|
Indians
|
157
|
13.0
|
|
Others
|
22
|
1.7
|
|
Age groups (years)
|
≤ 39
|
83
|
6.8
|
40–49
|
121
|
10.0
|
|
50–59
|
291
|
24.0
|
|
60–69
|
410
|
34.0
|
|
≥ 70
|
307
|
25.3
|
|
Co-morbidities
|
Hypertension
|
318
|
26.2
|
Diabetes
|
196
|
16.2
|
|
Site
|
Colon
|
596
|
49.2
|
Rectum
|
552
|
45.5
|
|
Unknown
|
64
|
5.3
|
|
Pre-operative carcino-embryonic antigen (CEA) level
|
Not elevated (≤ 5.0 ng/ml)
|
543
|
44.8
|
Elevated (> 5.0 ng/ml)
|
256
|
21.1
|
|
Unknown
|
413
|
34.1
|
|
Tumour Grades
|
Low
|
802
|
66.2
|
High
|
60
|
5.0
|
|
Unknown
|
350
|
28.8
|
|
Duke’s Stages
|
A&B
|
297
|
24.5
|
C
|
366
|
30.2
|
|
D
|
151
|
12.5
|
|
Unknown
|
398
|
32.8
|
|
Treatment modalities
|
Surgery alone
|
488
|
40.3
|
Surgery plus Chemo- or Radiotherapy
|
393
|
32.4
|
|
Surgery plus Chemo- and Radiotherapy
|
116
|
9.6
|
|
Chemo- and Radiotherapy alone
|
101
|
8.3
|
|
Best supportive care
|
114
|
9.4
|
|
Urgency of surgery
a
|
Elective
|
481
|
48.2
|
(
n = 997)
|
Emergency
|
134
|
13.4
|
Unknown
|
382
|
38.2
|
Relative and median survival rates
Cancer location
|
Relative survival rates (%)
|
Median survival (months)
|
---|---|---|
(95% CI)
|
(95% CI)
|
|
Colorectal cancer (
n = 1212)
|
42.00 (35.42–48.58)
|
|
1 year
|
74.92 (72.38–77.26)
|
|
3 years
|
53.13 (50.20–55.97)
|
|
5 years
|
42.85 (39.81, 45.84)
|
|
Colon cancer (
n = 596)
a
|
42.00 (31.11–52.89)
|
|
1 year
|
77.52 (73.95–80.66)
|
|
3 years
|
55.04 (50.81–59.07)
|
|
5 years
|
45.00 (40.59–49.31)
|
|
Rectal cancer (
n = 552)
a
|
41.00 (32.34–49.66)
|
|
1 year
|
74.09 (70.23–77.54)
|
|
3 years
|
52.47 (48.13–56.62)
|
|
5 years
|
41.26 (36.82–45.64)
|
Clinical characteristics
|
Survival rate, % (95% CI)
|
|||
---|---|---|---|---|
aMalay (
n = 225)
|
Chinese (
n = 808)
|
Indians (
n = 157)
|
p
|
|
Colorectal
|
48.50 (41.29–55.32)
|
39.68 (36.01–43.33)
|
47.49 (38.84–55.63)
|
0.039
|
Site:
|
||||
Colon
|
56.51 (44.75–66.69)
|
40.07 (34.86–45.22)
|
54.52 (42.18–65.29)
|
0.005
|
Rectum
|
43.87 (34.42–52.91)
|
39.81 (34.23–45.33)
|
36.91 (24.56–49.28)
|
0.674
|
Duke's stage
b
|
Malay (
n = 163)
|
Chinese (
n = 546)
|
Indians (
n = 105)
|
p
|
A & B
|
68.68 (51.43–80.88)
|
63.79 (55.88–70.66)
|
69.95 (51.73–82.39)
|
0.714
|
C
|
56.18 (42.43–67.86)
|
45.01 (37.96–51.80)
|
58.85 (41.56–72.61)
|
0.136
|
D
|
17.98 (6.27–34.53)
|
13.05 (7.03–20.96)
|
NA
|
-
|
Predictors of colorectal cancer survival
Variables
|
aCrude HR (95% CI)
|
bAdjusted HR (95% CI)
|
---|---|---|
Sex
|
||
Female
|
1.00
|
1.00
|
Male
|
1.13 (0.96–1.31)
|
1.41 (1.12–1.76)
|
Ethnicity
|
||
Malays
|
1.00
|
1.00
|
Chinese
|
1.26 (1.03–1.56)
|
1.41 (1.07–1.85)
|
Indians
|
1.06 (0.79–1.42)
|
1.32 (0.78–1.71)
|
Preoperative carcino-embryonic antigen (CEA) level
|
||
Not elevated
|
1.00
|
1.00
|
Elevated
|
2.31 (1.91–2.79)
|
2.13 (1.60–2.83)
|
Duke’s stages
|
||
A&B
|
1.00
|
1.00
|
C
|
1.66 (1.29–2.12)
|
1.68 (1.28–2.21)
|
D
|
4.94 (3.78–6.45)
|
4.61 (3.39–6.28)
|
Urgency of surgery
|
||
Elective
|
1.00
|
1.00
|
Emergency
|
1.42 (1.11–1.82)
|
1.52 (1.07–2.15)
|
Predictors
|
aCrude HR (95% CI)
|
bAdjusted HR (95% CI)
|
---|---|---|
Ethnicity
|
||
Malays
|
1.00
|
1.00
|
Chinese
|
1.55 (1.10–2.17)
|
1.74 (1.07–2.84)
|
Indians
|
1.13 (0.71–1.78)
|
1.88 (1.01–3.51)
|
Preoperative CEA levels
|
||
Not elevated
|
1.00
|
1.00
|
Elevated
|
2.58 (1.94–3.44)
|
2.00 (1.30–3.03)
|
Duke’s stages
|
||
A&B
|
1.00
|
1.00
|
C
|
2.13 (1.49–3.05)
|
2.33 (1.56–3.49)
|
D
|
5.51 (3.73–8.16)
|
5.87 (3.73–9.24)
|
Predictors
|
aCrude HR (95% CI)
|
bAdjusted HR (95% CI)
|
---|---|---|
Sex
|
||
Female
|
1.00
|
1.00
|
Male
|
1.27 (1.02–1.60)
|
1.68 (1.19–2.37)
|
Preoperative carcino-embryonic antigen (CEA) level
|
||
Not elevated
|
1.00
|
1.00
|
Elevated
|
2.03 (1.55–2.65)
|
2.09 (1.39–2.37)
|
Duke’s stages
|
||
A&B
|
1.00
|
1.00
|
C
|
1.27 (0.89–1.80)
|
1.16 (0.79–1.72)
|
D
|
3.98 (2.37–5.80)
|
3.97 (2.59–6.10)
|
Tumour grades
|
||
Low
|
1.00
|
1.00
|
High
|
2.99 (1.92–4.67)
|
2.91 (1.65–5.14)
|