Population-based assessment of the outcomes in patients with postcolonoscopy colorectal cancers.
Gut
; 65(6): 971-6, 2016 06.
Article
em En
| MEDLINE
| ID: mdl-25748649
ABSTRACT
OBJECTIVE:
The potential for cancers to not be detected on colonoscopy is increasingly recognised, but little is known about patient outcomes. The objective of this study was to assess the outcomes of patients diagnosed with postcolonoscopy colorectal cancers (PCCRCs).DESIGN:
We conducted a population-based retrospective cohort study, including all patients diagnosed with colorectal cancer (CRC) in Ontario, Canada from 2003 to 2009. Patients were categorised into three groups DETECTED (diagnosed within 6â months of first colonoscopy), PCCRC (diagnosed 6-36â months after first colonoscopy) or NOSCOPE (no colonoscopy within 36â months of diagnosis). Univariate and multivariable analyses were conducted to study overall survival, surgical treatment, emergency presentation and surgical complications.RESULTS:
Overall, 45â 104 patients were included, with 2804 being classified as having a PCCRC. Compared with the DETECTED group, PCCRC was associated with a significantly higher likelihood of stage IV disease (17.2% vs 12.9%), worse overall survival (5â year OS 60.8% vs 68.3%, p<0.0001; adjusted HR 1.25, 95% CI 1.17 to 1.32, p<0.0001), a higher likelihood of emergency presentation (OR 2.86, 95% CI 2.56 to 3.13, p<0.001) and lower likelihood of surgical resection (OR 0.61, 95% CI 0.55 to 0.67, p<0.001). However, patients with PCCRC had significantly better outcomes than those in the NOSCOPE group (stage IV 37.1%, 5â year OS 38.9%)CONCLUSIONS:
Compared with CRC detected by colonoscopy, PCCRCs are associated with a higher risk of emergent presentation, a lower likelihood of surgical resection and most notably, significantly worse oncological outcomes. However, they have better outcomes than patients with no recent colonoscopy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Colonoscopia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Gut
Ano de publicação:
2016
Tipo de documento:
Article