Abstract
e14626 Background: We studied demographics, comorbidity, treatment, and other predictors of survival for patients (pts) with CRC to define the natural history Methods: In an IRB-approved protocol, we reviewed the records of pts diagnosed with CRC at a VA medical center from 01/01/2003 to 12/31/2012. Demographics, grade, stage, ECOG performance status (PS), CEA, Hemoglobin (HGB), and Albumin (ALB) at diagnosis, diagnosis by screening, cause of death, recurrence, survival, and treatment were studied. Comorbidity was assessed with the Charlson Comorbidity Index (CCI). Statistical analyses were performed with SAS 9.2 and Stata v11.0. Results: There were 296 pts with 294 men and 2 women. The median (M) age was 69 years (44-90). There were 4 (1.4%) pts with stage 0, 95 (33%) with stage I, 72(25%) stage II, 56(20%) with stage III, 57(20%) with stage IV CRC. The percentage of pts diagnosed by screening varied inversely with stage, from 43% (41 pts) for stage I, 22% (16 pts) for stage II, 20% (11 pts) for stage III, to 2% (1 pt) for stage IV (p<.001). M survival (MS) was 1,126 days (4-4004) with 143 pts (48%) deceased. Survival varied inversely with stage, with median survivals of 1,548 days for stage I, 1,557 days for stage II, 1011 days for stage III, and 413 days stage IV CRC pts (p<.001). Surgery was done in 232 pts (78%), chemotherapy in 102 pts (33%). Median ECOG PS was 1(0-4) and Charlson 4.1 (0.8-13.9). Death from CRC occurred in 5 (5%) pts with stage I, 17 (24%) pts with stage II, 15 (27%) pts with stage III, and 37(65%) pts with stage IV CRC (p<.001). Recurrence was experienced by 22 early stage pts (9%). For all stages, M HGB was 12.4 (6.5-16.7) gm/dl, CEA 2.5 (0.2-2071) ng/ml, and albumin 4.0 (2.1-4.8) gm/dl at diagnosis. By univariate analysis, stage (p<.001), HGB (p<.001), grade (p<.001), ECOG PS (p<.001), CCI (p<.001), CEA (p<.001), surgery (p<.001), chemotherapy (.049), and diagnosis by screening (p<.001) were predictive. In multivariate model, stage, Charlson, chemotherapy, ECOG PS, and albumin levels were predictive. Conclusions: In this study population, screening colonoscopy and chemotherapy are showing an effect on survival. Confirmation in large patient samples is planned. Supported by NJCCR
Published Version
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