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BMC Cancer  2010 

Tumor location and patient characteristics of colon and rectal adenocarcinomas in relation to survival and TNM classes

DOI: 10.1186/1471-2407-10-688

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Abstract:

The Swedish Family-Cancer Database has data on TNM classes on 6,105 CRC adenocarcinoma patients. Ordinal logistic regression analysis was performed to model tumor characteristics according to age at diagnosis, tumor localization, gender, socioeconomic status, medical region and family history. The results were compared to results from survival analysis.The only parameters systematically associated with TNM classes were age and tumor localization. Young age at diagnosis was a risk factor for aggressive CRC, according to stage, N and M with odds ratios (ORs) ranging from 1.80 to 1.93 for diagnosis before age 50 years compared to diagnosis at 80+ years. All tumor characteristics, particularly T, were worse for colon compared to rectal tumors. Right-sided tumors showed worse characteristics for all classifiers but M. The survival analysis on patients diagnosed since 2000 showed a hazard ratio of 0.55 for diagnosis before age 50 years compared to diagnosis at over 80 years and a modestly better prognosis for left-sided compared to right-sided tumors.The results showed systematically more aggressive tumors in young compared to old patients. The poorer survival of old patients in colon cancer was not related to the available tumor characteristics. However, these partially agreed with the limited colonoscopic success with right-sided tumors.Mortality in colorectal cancer (CRC) has declined in the developed countries because the incidence has no longer increased and because the survival has improved [1-3]. Adenocarcinoma is the most common histology of colon and rectal cancers. The 5-year survival for colon adenocarcinoma reached about 60% in Sweden towards the end of the 1990s being a few percentage points better for women compared to men [4]; for rectal adenocarcinoma the male survival was about 55% compared to over 60% for women. The reasons for the improvements in survival have been suggested to be earlier diagnosis and better health status and care [4,5]. However, the f

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