Challenging a dogma: five-year survival does not equal cure in all colorectal cancer patients

ABSTRACT

Background: The current study tried to evaluate the factors affecting 10- to 20- years’ survival among long term survivors (>5 years) of colorectal cancer (CRC).

Methods: Surveillance, Epidemiology and End Results (SEER) database (1988-2008) was queried through SEER*Stat program.Univariate probability of overall and cancer-specific survival was determined and the difference between groups was examined. Multivariate analysis for factors affecting overall and cancer-specific survival was also conducted.

Results: Among node positive patients (Dukes C), 34% of the deaths beyond 5 years can be attributed to CRC; while among M1 patients, 63% of the deaths beyond 5 years can be attributed to CRC. The following factors were predictors of better overall survival in multivariate analysis: younger age, white race (versus black race), female gender, Right colon location (versus rectal location), earlier stage and surgery (P <0.0001 for all parameters). Similarly, the following factors were predictors of better cancer-specific survival in multivariate analysis: younger age, white race (versus black race), female gender, Right colon location (versus left colon and rectal locations), earlier stage and surgery (P <0.0001 for all parameters).

Conclusion: Among node positive long-term CRC survivors, more than one third of all deaths can be attributed to CRC.

KEYWORDS:

• Colon cancer
• rectal cancer
• five years
• survival
• cure

Author contributions

Omar Abdel-Rahman was involved in the conception and design, analysis and interpretation of the data; the drafting of the paper; and the final approval of the version to be published.

Declaration of Interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not received any funding.