Colorectal carcinoma survival among hereditary nonpolyposis colorectal carcinoma family members

Patrice Watson, Kevin M. Lin, Miguel A. Rodriguez-Bigas, Thomas Christopher Smyrk, Stephen Lemon, M. Shashidharan, Barbara Franklin, Beth Karr, Alan Thorson, Henry T. Lynch

Research output: Contribution to journalArticle

197 Citations (Scopus)

Abstract

BACKGROUND. Patients with hereditary nonpolyposis colorectal carcinoma (HNPCC) reportedly have better prognoses than sporadic colorectal carcinoma (CRC) patients, but it has been unclear whether this could be due to differences in stage at diagnosis. The current study compared stage and survival in a retrospective cohort of HNPCC family members who developed CRC with the same factors in an unselected hospital series of patients with sporadic CRC. METHODS. This retrospective cohort study compared HNPCC cases (274 cases from 98 HNPCC families) with an unselected hospital series comprising 820 consecutive CRC cases. All patients were staged according to the TNM system of the American Joint Committee on Cancer and the International Union Against Cancer. Median follow-up among living patients was > 10 years and 8.5 years, respectively, for the two cohorts. Cox regression was used to compare survival in stage-stratified analyses of time from diagnosis to death. RESULTS. Compared with the unselected series, the HNPCC cases had lower stage disease (P < 0.001), and fewer had distant metastases at diagnosis (P < 0.001 in an analysis stratified by T classification). In stage-stratified survival analysis, the HNPCC cases had a significant overall survival advantage regardless of adjustment for their younger age. A conservative estimate of the hazard ratio (of HNPCC cases to the unselected series) was 0.67 (P < 0.0012). CONCLUSIONS. HNPCC patients had lower stage disease at diagnosis than the unselected CRC cases, mainly due to rarer distant metastases at diagnosis. They survived longer than unselected CRC patients with tumors of the same stage. The estimated death rate for the HNPCC cases, adjusted for stage and age differences, was at most two-thirds of the rate for the hospital series.

Original languageEnglish (US)
Pages (from-to)259-266
Number of pages8
JournalCancer
Volume83
Issue number2
DOIs
StatePublished - Jul 15 1998
Externally publishedYes

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Colorectal Neoplasms
Survival
Neoplasm Metastasis
Survival Analysis
Neoplasms
Cohort Studies
Retrospective Studies

Keywords

  • AJCC/UICC TNM staging
  • Hereditary nonpolyposis colorectal carcinoma
  • Metastasis
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Watson, P., Lin, K. M., Rodriguez-Bigas, M. A., Smyrk, T. C., Lemon, S., Shashidharan, M., ... Lynch, H. T. (1998). Colorectal carcinoma survival among hereditary nonpolyposis colorectal carcinoma family members. Cancer, 83(2), 259-266. https://doi.org/10.1002/(SICI)1097-0142(19980715)83:2<259::AID-CNCR9>3.0.CO;2-L

Colorectal carcinoma survival among hereditary nonpolyposis colorectal carcinoma family members. / Watson, Patrice; Lin, Kevin M.; Rodriguez-Bigas, Miguel A.; Smyrk, Thomas Christopher; Lemon, Stephen; Shashidharan, M.; Franklin, Barbara; Karr, Beth; Thorson, Alan; Lynch, Henry T.

In: Cancer, Vol. 83, No. 2, 15.07.1998, p. 259-266.

Research output: Contribution to journalArticle

Watson, P, Lin, KM, Rodriguez-Bigas, MA, Smyrk, TC, Lemon, S, Shashidharan, M, Franklin, B, Karr, B, Thorson, A & Lynch, HT 1998, 'Colorectal carcinoma survival among hereditary nonpolyposis colorectal carcinoma family members', Cancer, vol. 83, no. 2, pp. 259-266. https://doi.org/10.1002/(SICI)1097-0142(19980715)83:2<259::AID-CNCR9>3.0.CO;2-L
Watson, Patrice ; Lin, Kevin M. ; Rodriguez-Bigas, Miguel A. ; Smyrk, Thomas Christopher ; Lemon, Stephen ; Shashidharan, M. ; Franklin, Barbara ; Karr, Beth ; Thorson, Alan ; Lynch, Henry T. / Colorectal carcinoma survival among hereditary nonpolyposis colorectal carcinoma family members. In: Cancer. 1998 ; Vol. 83, No. 2. pp. 259-266.
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abstract = "BACKGROUND. Patients with hereditary nonpolyposis colorectal carcinoma (HNPCC) reportedly have better prognoses than sporadic colorectal carcinoma (CRC) patients, but it has been unclear whether this could be due to differences in stage at diagnosis. The current study compared stage and survival in a retrospective cohort of HNPCC family members who developed CRC with the same factors in an unselected hospital series of patients with sporadic CRC. METHODS. This retrospective cohort study compared HNPCC cases (274 cases from 98 HNPCC families) with an unselected hospital series comprising 820 consecutive CRC cases. All patients were staged according to the TNM system of the American Joint Committee on Cancer and the International Union Against Cancer. Median follow-up among living patients was > 10 years and 8.5 years, respectively, for the two cohorts. Cox regression was used to compare survival in stage-stratified analyses of time from diagnosis to death. RESULTS. Compared with the unselected series, the HNPCC cases had lower stage disease (P < 0.001), and fewer had distant metastases at diagnosis (P < 0.001 in an analysis stratified by T classification). In stage-stratified survival analysis, the HNPCC cases had a significant overall survival advantage regardless of adjustment for their younger age. A conservative estimate of the hazard ratio (of HNPCC cases to the unselected series) was 0.67 (P < 0.0012). CONCLUSIONS. HNPCC patients had lower stage disease at diagnosis than the unselected CRC cases, mainly due to rarer distant metastases at diagnosis. They survived longer than unselected CRC patients with tumors of the same stage. The estimated death rate for the HNPCC cases, adjusted for stage and age differences, was at most two-thirds of the rate for the hospital series.",
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AU - Watson, Patrice

AU - Lin, Kevin M.

AU - Rodriguez-Bigas, Miguel A.

AU - Smyrk, Thomas Christopher

AU - Lemon, Stephen

AU - Shashidharan, M.

AU - Franklin, Barbara

AU - Karr, Beth

AU - Thorson, Alan

AU - Lynch, Henry T.

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N2 - BACKGROUND. Patients with hereditary nonpolyposis colorectal carcinoma (HNPCC) reportedly have better prognoses than sporadic colorectal carcinoma (CRC) patients, but it has been unclear whether this could be due to differences in stage at diagnosis. The current study compared stage and survival in a retrospective cohort of HNPCC family members who developed CRC with the same factors in an unselected hospital series of patients with sporadic CRC. METHODS. This retrospective cohort study compared HNPCC cases (274 cases from 98 HNPCC families) with an unselected hospital series comprising 820 consecutive CRC cases. All patients were staged according to the TNM system of the American Joint Committee on Cancer and the International Union Against Cancer. Median follow-up among living patients was > 10 years and 8.5 years, respectively, for the two cohorts. Cox regression was used to compare survival in stage-stratified analyses of time from diagnosis to death. RESULTS. Compared with the unselected series, the HNPCC cases had lower stage disease (P < 0.001), and fewer had distant metastases at diagnosis (P < 0.001 in an analysis stratified by T classification). In stage-stratified survival analysis, the HNPCC cases had a significant overall survival advantage regardless of adjustment for their younger age. A conservative estimate of the hazard ratio (of HNPCC cases to the unselected series) was 0.67 (P < 0.0012). CONCLUSIONS. HNPCC patients had lower stage disease at diagnosis than the unselected CRC cases, mainly due to rarer distant metastases at diagnosis. They survived longer than unselected CRC patients with tumors of the same stage. The estimated death rate for the HNPCC cases, adjusted for stage and age differences, was at most two-thirds of the rate for the hospital series.

AB - BACKGROUND. Patients with hereditary nonpolyposis colorectal carcinoma (HNPCC) reportedly have better prognoses than sporadic colorectal carcinoma (CRC) patients, but it has been unclear whether this could be due to differences in stage at diagnosis. The current study compared stage and survival in a retrospective cohort of HNPCC family members who developed CRC with the same factors in an unselected hospital series of patients with sporadic CRC. METHODS. This retrospective cohort study compared HNPCC cases (274 cases from 98 HNPCC families) with an unselected hospital series comprising 820 consecutive CRC cases. All patients were staged according to the TNM system of the American Joint Committee on Cancer and the International Union Against Cancer. Median follow-up among living patients was > 10 years and 8.5 years, respectively, for the two cohorts. Cox regression was used to compare survival in stage-stratified analyses of time from diagnosis to death. RESULTS. Compared with the unselected series, the HNPCC cases had lower stage disease (P < 0.001), and fewer had distant metastases at diagnosis (P < 0.001 in an analysis stratified by T classification). In stage-stratified survival analysis, the HNPCC cases had a significant overall survival advantage regardless of adjustment for their younger age. A conservative estimate of the hazard ratio (of HNPCC cases to the unselected series) was 0.67 (P < 0.0012). CONCLUSIONS. HNPCC patients had lower stage disease at diagnosis than the unselected CRC cases, mainly due to rarer distant metastases at diagnosis. They survived longer than unselected CRC patients with tumors of the same stage. The estimated death rate for the HNPCC cases, adjusted for stage and age differences, was at most two-thirds of the rate for the hospital series.

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