Survival and treatment trends for advanced colorectal cancer (CRC) treated in a University Hospital, 1992–2001

Abstract

3707 Background: Over the last decade significant improvements in the outcome for patients with advanced CRC has been achieved. We have reviewed the prospective CRC database at our hospital from 1992 to 2001 to explore whether the availability of new chemotherapy drugs (irinotecan and oxaliplatin) and surgical advances has impacted on survival. Method: Two time periods were analysed: 1/1/92- 31/12/97 & 1/1/98–12/31/01 reflecting the availability of these new drugs in Australia. Two distinct patient groups for each period were analysed; advanced disease (Ad) at diagnosis & patients with Dukes A, B & C disease (abc) at recurrence. Results: There were a total of 541 cases diagnosed with advanced or recurrent CRC available for baseline characteristics. Treatment received is shown in table 1. & has both altered & increased with time, although overall chemotherapy use remains relatively low. The percentage of relapsing v advanced disease reduced over time. The overall 18 month survivals pre & post 98 are as follows; 92–97 - 33.3% (+3.9), 98–01 - 49.0% (± 5.0). Median survivals were; 92–97 - 11.2 months, 98–01 - 15.1 months. Survival specifically for the abc group was higher for those diagnosed after 1998 (RR 0.63, 047–0.85). The 36 month survival for this group was 23% v 44%. Conclusions: These data suggest that a number of factors have contributed to the trend of improved survival & these include improved access and availability of effective chemotherapy, increased hepatic resection rates, second line chemotherapy & improved staging diagnosing patients with advanced disease earlier, ie stage migration. Additional data will be presented. No significant financial relationships to disclose.