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Eur J Cancer. 2013 Sep;49(13):2919-25. doi: 10.1016/j.ejca.2013.04.001. Epub 2013 Apr 30.

Improvement in survival of metastatic colorectal cancer: are the benefits of clinical trials reproduced in population-based studies?

Author information

1
Institut Curie, Département d'Oncologie Médicale, 35 Rue Dailly, 92210 Saint-Cloud, France.

Abstract

AIM OF THE STUDY:

To describe trends in survival of non-resectable metastatic colorectal cancer (MCRC) over a 34-year period in a French population-based registry taking into account major advances in medical therapy.

PATIENTS AND METHODS:

3804 patients with non-resectable metastatic colorectal cancer diagnosed between 1976 and 2009 were included. Three periods (1976-96, 1997-2004 and 2005-09) were considered.

RESULTS:

The proportion of patients receiving chemotherapy dramatically increased from 19% to 57% between the first two periods, then increased steadily thereafter reaching 59% during the last period (p<0.001). Median relative survival increased from 5.9 months during the 1976-96 period to 10.2 months during the 1997-2004 period but, despite the availability of targeted therapies, remained at 9.5 months during the 2005-09 period. During the last study period, less than 10% of elderly patients received targeted therapies compared to more than 40% for younger patients. Their median relative survival was 5.0 months compared to 15.6 months in younger patients.

CONCLUSION:

There was an improvement in survival in relation with the increased use of more effective medical treatment. However, at a population-based level, patients are not all treated equally and most of them, especially the elderly, do not benefit from the most up-to-date treatment options.

KEYWORDS:

Chemotherapy; Colorectal cancer; Elderly; Population-based study; Survival; Targeted therapies

PMID:
23642328
DOI:
10.1016/j.ejca.2013.04.001
[Indexed for MEDLINE]

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