Abstract
Background:This study investigated the overall survival (OS) at 1-year, 3-years, and 5-years after colorectal cancer (CRC) diagnosis and examined the prognostic factors of mortality among patients with CRC in Vietnam’s central region. Methods:This ambidirectional cohort study included patients newly diagnosed with CRC at a tertiary hospital in Vietnam’s central region between 2013 and 2019. Survival duration was calculated from the surgery date or the first day of CRC-specific treatment until the date of death or the study’s end date, July 31, 2020. Kaplan-Meier methods and log-rank test were used to estimate and compare the OS between the subgroups, respectively. The Cox proportional-hazards (PH) regression analysis was applied to estimate the magnitude of the effects between prognostic factors and outcome. Results:The median follow-up was 24 months (interquartile range: 13–43 months). The OS rate dropped significantly to 84.7%, 56.19%, and 45.01% at 1-year, 3-years, and 5-years after diagnosis, respectively. The median OS was 48.59 months (39.34 –57.93 months) for the rectum and colon cases. In the multivariate analysis, a higher mortality risk was observed in patients with an advanced-stage CRC (HRadj, 3.04; 95% confidence interval [CI], 1.79–5.18), who were underweight (<18.5 kg/m2; HRadj, 1.65; 95%CI, 1.03–2.65), and had elevated preoperative carcinoembryonic antigen (CEA) level (>5.0 ng/mL; HRadj, 1.63; 95%CI, 1.03–2.59). Additionally, younger patients (<50 years) had a poorer OS than the middle-aged group (60–69 years). Conclusion:Our findings indicate that <50% of Vietnamese patients with CRC survive until 5-years after diagnosis. Several individual factors that contribute to the poor OS of patients with CRC, including young age, underweight, and elevated preoperative CEA level, should be evaluated and managed. Early diagnoses through active routine examination of or screening programs for high-risk groups should be prioritized.
Highlights
The burden of colorectal cancer (CRC) has become an important public health issue, which is predicted to increase by 60%, with 2.2 million incident cases and 1.1 deaths by 2030 (Arnold et al, 2017)
The incidence of CRC continues to rise (Rawla et al, 2019), and the trend patterns of the disease correlate with the present human development levels, which may reflect the adoption of more Western lifestyles (Arnold et al, 2017)
In 2020, more than one in two new CRC cases occurred in Asian countries (Ferlay et al, 2020)
Summary
The burden of colorectal cancer (CRC) has become an important public health issue, which is predicted to increase by 60%, with 2.2 million incident cases and 1.1 deaths by 2030 (Arnold et al, 2017). According to the 2020 GLOBOCAN report, CRC is the second leading cause of cancer-related deaths based on cancer sites worldwide, which is estimated at 9.2% (Ferlay et al, 2020) Both CRC incidence and mortality are declining in many developed countries, the trend has increased in several Asian countries (Arnold et al, 2017; Wild et al, 2020). The survival rate of cancer patients is an essential indicator that reflects the effectiveness of cancer-specific treatment as well as preventive and cancer control programs (Li et al, 2019). This study investigated the overall survival (OS) at 1-year, 3-years, and 5-years after colorectal cancer (CRC) diagnosis and examined the prognostic factors of mortality among patients with CRC in Vietnam’s central region. Diagnoses through active routine examination of or screening programs for high-risk groups should be prioritized
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
