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PLOS ONE  2013 

Differences in Survival between Colon and Rectal Cancer from SEER Data

DOI: 10.1371/journal.pone.0078709

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Background Little is known about colorectal cancer or colon and rectal cancer. Are they the same disease or different diseases? Objectives The aim of this epidemiology study was to compare the features of colon and rectal cancer by using recent national cancer surveillance data. Design and setting Data included colorectal cancer (1995–2008) from the Surveillance, Epidemiology, and End Results Program (SEER) database. Only adenocarcinoma was included for analysis. Patients A total of 372,130 patients with a median follow-up of 32 months were analyzed. Main outcome measures Mean survival of patients with the same stage of colon and rectal cancer was evaluated. Results Around 35% of patients had stage information. Among them, colon cancer patients had better survival than those with rectal cancer, by a margin of 4 months in stage IIB. In stage IIIC and stage IV, rectal cancer patients had better survival than colon cancer patients, by about 3 months. Stage IIB colorectal cancer patients had a poorer prognosis than those with stage IIIA and IIIB colorectal cancer. After adjustment of age, sex and race, colon cancer patients had better survival than rectal cancer of stage IIB, but in stage IIIC and IV, rectal cancer patients had better survival than colon cancer. Limitations The study is limited by its retrospective nature. Conclusion This was a population-based study. The prognosis of rectal cancer was not worse than that of colon cancer. Local advanced colorectal cancer had a poorer prognosis than local regional lymph node metastasis. Stage IIB might require more aggressive chemotherapy, and no less than that for stage III.


[1]  Ferlay J SH, Bray F, Forman D, Mathers C, Parkin DM (2008) GLOBOCAN v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010.
[2]  Andre T, Boni C, Mounedji-Boudiaf L, Navarro M, Tabernero J, et al. (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350: 2343–2351.
[3]  Rosenberg R, Maak M, Schuster T, Becker K, Friess H, et al. (2010) Does a rectal cancer of the upper third behave more like a colon or a rectal cancer? Dis Colon Rectum 53: 761–770.
[4]  National Cancer Institute: Surveillance E, and Results: SEER stat fact sheets-all sites. Acessed 2013 Sep 26.
[5]  Stephen B (2010). AJCC Cancer staging handbook seventh edition. 177–183.
[6]  Jarvinen R, Knekt P, Hakulinen T, Rissanen H, Heliovaara M (2001) Dietary fat, cholesterol and colorectal cancer in a prospective study. Br J Cancer 85: 357–361.
[7]  Jenab M, Bueno-de-Mesquita HB, Ferrari P, van Duijnhoven FJ, Norat T, et al. (2010) Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ 340: b5500.
[8]  de Vogel S, Dindore V, van Engeland M, Goldbohm RA, van den Brandt PA, et al. (2008) Dietary folate, methionine, riboflavin, and vitamin B-6 and risk of sporadic colorectal cancer. The Journal Of Nutrition 138: 2372–2378.
[9]  Kune G, Watson L (2006) Colorectal cancer protective effects and the dietary micronutrients folate, methionine, vitamins B6, B12, C, E, selenium, and lycopene. Nutrition And Cancer 56: 11–21.
[10]  Zschabitz S, Cheng TY, Neuhouser ML, Zheng Y, Ray RM, et al. (2013) B vitamin intakes and incidence of colorectal cancer: results from the Women’s Health Initiative Observational Study cohort. Am J Clin Nutr 97: 332–343.
[11]  Harnack L, Jacobs DR Jr, Nicodemus K, Lazovich D, Anderson K, et al. (2002) Relationship of folate, vitamin B-6, vitamin B-12, and methionine intake to incidence of colorectal cancers. Nutr Cancer 43: 152–158.
[12]  Yin L, Grandi N, Raum E, Haug U, Arndt V, et al. (2009) Meta-analysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther 30: 113–125.
[13]  Wakai K, Hirose K, Matsuo K, Ito H, Kuriki K, et al. (2006) Dietary risk factors for colon and rectal cancers: a comparative case-control study. J Epidemiol 16: 125–135.
[14]  Chan DS, Lau R, Aune D, Vieira R, Greenwood DC, et al. (2011) Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. Plos One 6: e20456.
[15]  Larsson SC, Wolk A (2006) Meat consumption and risk of colorectal cancer: a meta-analysis of prospective studies. Int J Cancer 119: 2657–2664.
[16]  Harriss DJ, Atkinson G, Batterham A, George K, Cable NT, et al. (2009) Lifestyle factors and colorectal cancer risk (2): a systematic review and meta-analysis of associations with leisure-time physical activity. Colorectal Dis 11: 689–701.
[17]  Samad AK, Taylor RS, Marshall T, Chapman MA (2005) A meta-analysis of the association of physical activity with reduced risk of colorectal cancer. Colorectal Dis 7: 204–213.
[18]  Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels AB, et al. (2008) Smoking and colorectal cancer: a meta-analysis. JAMA 300: 2765–2778.
[19]  Liang PS, Chen TY, Giovannucci E (2009) Cigarette smoking and colorectal cancer incidence and mortality: systematic review and meta-analysis. Int J Cancer 124: 2406–2415.
[20]  Gong J, Hutter C, Baron JA, Berndt S, Caan B, et al. (2012) A pooled analysis of smoking and colorectal cancer: timing of exposure and interactions with environmental factors. Cancer Epidemiol Biomarkers Prev 21: 1974–1985.
[21]  Slattery ML, Curtin K, Wolff RK, Boucher KM, Sweeney C, et al. (2009) A comparison of colon and rectal somatic DNA alterations. Dis Colon Rectum 52: 1304–1311.
[22]  Aamodt R, Jonsdottir K, Andersen SN, Bondi J, Bukholm G, et al. (2009) Differences in protein expression and gene amplification of cyclins between colon and rectal adenocarcinomas. Gastroenterol Res Pract 2009: 285830.
[23]  Cancer Genome Atlas Network (2012) Comprehensive molecular characterization of human colon and rectal cancer. Nature 487: 330–337.
[24]  Birkenkamp-Demtroder K, Olesen SH, Sorensen FB, Laurberg S, Laiho P, et al. (2005) Differential gene expression in colon cancer of the caecum versus the sigmoid and rectosigmoid. Gut 54: 374–384.
[25]  Bos JL, Fearon ER, Hamilton SR, Verlaan-de Vries M, van Boom JH, et al. (1987) Prevalence of ras gene mutations in human colorectal cancers. Nature 327: 293–297.
[26]  Forrester K, Almoguera C, Han K, Grizzle WE, Perucho M (1987) Detection of high incidence of K-ras oncogenes during human colon tumorigenesis. Nature 327: 298–303.
[27]  Andreyev HJ, Norman AR, Cunningham D, Oates J, Dix BR, et al. (2001) Kirsten ras mutations in patients with colorectal cancer: the ‘RASCAL II’ study. Br J Cancer 85: 692–696.
[28]  Erben P, Strobel P, Horisberger K, Popa J, Bohn B, et al. (2011) KRAS and BRAF mutations and PTEN expression do not predict efficacy of cetuximab-based chemoradiotherapy in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 81: 1032–1038.
[29]  Servomaa K, Kiuru A, Kosma VM, Hirvikoski P, Rytomaa T (2000) p53 and K-ras gene mutations in carcinoma of the rectum among Finnish women. Mol Pathol 53: 24–30.
[30]  Davies JM, Trembath D, Deal AM, Funkhouser WK, Calvo BF, et al. (2011) Phospho-ERK and AKT status, but not KRAS mutation status, are associated with outcomes in rectal cancer treated with chemoradiotherapy. Radiat Oncol 6: 114.
[31]  Luna-Perez P, Segura J, Alvarado I, Labastida S, Santiago-Payan H, et al. (2000) Specific c-K-ras gene mutations as a tumor-response marker in locally advanced rectal cancer treated with preoperative chemoradiotherapy. Ann Surg Oncol 7: 727–731.
[32]  Samowitz WS, Curtin K, Wolff RK, Tripp SR, Caan BJ, et al. (2009) Microsatellite instability and survival in rectal cancer. Cancer Causes Control 20: 1763–1768.
[33]  Ueo H, Maehara Y, Saito A, Sakaguchi Y, Kohnoe S, et al. (1991) Human colon cancer tissues are more sensitive than rectal cancer tissues to antitumor drugs in vitro. Oncology 48: 158–161.
[34]  Li JN, Zhao L, Wu J, Wu B, Yang H, et al. (2012) Differences in gene expression profiles and carcinogenesis pathways between colon and rectal cancer. J Dig Dis 13: 24–32.
[35]  Li M, Li JY, Zhao AL, Gu J (2007) Colorectal cancer or colon and rectal cancer? Clinicopathological comparison between colonic and rectal carcinomas. Oncology 73: 52–57.
[36]  McDermott FT, Hughes ES, Pihl E, Milne BJ, Price AB (1981) Comparative results of surgical management of single carcinomas of the colon and rectum: a series of 1939 patients managed by one surgeon. Br J Surg 68: 850–855.


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