Gender specificity in the interpretation of treatment results for patients with colorectal cancer in the Republic of Tatarstan

Abstract

Objective - to identify the gender-specific features of modeling the prognosis of treatment outcomes for patients with colorectal cancer (CRC). Materials and methods. The study included 654 patients with colorectal cancer (CRC) who were treated from 2013 to 2015, of which 434 were men, 220 were women. The average age of the patients was 64.1±10.2 years. All patients underwent genetic analysis for the presence of a mutation in the KRAS gene from the primary tumor. Results. The gender approach to assessing the long-term results of treatment of patients with CRC showed that in men with colorectal cancer, the most favorable treatment results were observed in patients with tumors in stage T 1-2 N0 M0, regardless of the differentiation of the tumor and its mutational status. In men, poorly differentiated tumors with any T, with the presence of regional metastases and a mutation of the KRAS gene, even in the absence of distant metastases, should be considered prognostically unfavorable: not a single patient lived for 5 years. In women, based on the decision tree analysis, the most favorable treatment results were observed in patients with tumors in the stage T 1-2-3 N0 M0 under the age of 70 years (five-year survival rate of 90%), with tumors T 1-2 N0 M0 - over the age of 70 years (five-year survival of 81.8%), regardless of the differentiation of the tumor and its mutational status. Tumors of any differentiation of the T3-4 N0 stage with the presence of distant metastases (5% of patients lived for 5 years) and poorly differentiated T4N0M0 tumors (five-year survival of 8%) are prognostically unfavorable for women. Conclusion. The study of gender and age-related features of the development and course of CRC is relevant for oncologists to select effective diagnostic, therapeutic and rehabilitation measures.