Survival analysis of colorectal cancer patients in a Thai hospital-based cancer registry

ABSTRACT

Background: The study aimed to assess the overall and stage-specific colorectal cancer (CRC) survival and to identify the prognostic factors for survival among Thai patients.

Research design and methods: The retrospective data of CRC patients from a university hospital-based cancer registry from 2001 to 2014 were used to estimate five-year overall survival (OS). Kaplan–Meier method and log-rank tests were used to assess the differences in five-year OS by age at diagnosis, diagnostic period, tumor site, stage at diagnosis and treatment modalities. A multivariate Cox’s proportional hazard model was used to identify independent prognostic factors for the OS.

Results: A total of 1,507 (48%) colon and 1,648 (52%) rectal cancer patients were included. Five-year OS for CRC patients was 44%. It differed significantly by stage, age group, and treatment received. Stage at diagnosis, age group, diagnostic period, receiving surgical and chemotherapy treatments were prognostic factors for OS.

Conclusions: An increasing trend in the number of CRC patients mostly at stage III and IV was found. Our results emphasized that an improvement in CRC survival could be achieved through the adoption of advanced cancer therapies, as well as improved access to quality diagnosis and timely treatment.

KEYWORDS:

• colorectal cancer
• colon cancer
• rectal cancer
• survival
• Thailand

Article highlights

• Overall and stage-specific survival of 3,155 colorectal cancer patients from a hospital-based cancer registry in Thailand from 2001 to 2014 were evaluated.

• The five-year survival for CRC patients in the cohort was increased from 42% to 46% between the diagnostic periods of 2001–2007 and 2008–2014.

• This study confirmed that the stage at diagnosis, age group, diagnostic period, and receiving surgical and chemotherapy treatments were associated to survival.

Acknowledgments

The authors would like to thank the Center of Registry Unit, Faculty of Medicine, Prince of Songkla University for providing data as well as the Department of Pharmacy, Faculty of Pharmacy, Mahidol University for supporting the research facility.

Author Contributions

K Kittrongsiri performed data analysis and interpretation as well as drafted and revised the paper. W Wanichsuwan and P Prechawittayakul participated in the analysis and interpretation of data and the drafting of the paper. S Sangroongruangsri was involved in data interpretation and the revising of the paper. J Cairns was involved in the conception and design, analysis, and interpretation of the data, and the drafting of the paper. U Chaikledkaew was involved in the conception and design, analysis and interpretation of the data, the drafting of the paper and revising it critically for intellectual content. All authors granted the final approval of the version to be published and agreed to be accountable for all aspects of the work.

Declaration of Interest

The authors have no other 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.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by the Royal Golden Jubilee Ph. D. Program, the Thailand Research Fund (TRF) (grant number PHD/0234/2553) and is a part of study in Doctor of Philosophy program in Social, Economic, and Administrative Pharmacy (SEAP) and received research supplies fee from the Faculty of Graduate Studies, Mahidol University