Trends in the Characteristics, Treatment, and Outcomes of Rectal Adenocarcinoma in the US From 2004 to 2019

医学 结直肠癌 腺癌 回顾性队列研究 内科学 癌症
作者
Sameh Hany Emile,Nir Horesh,Michael R. Freund,Zoe Garoufalia,Rachel Gefen,Emanuela Silva‐Alvarenga,David J. Maron,Giovanna Dasilva,Steven D. Wexner
出处
期刊:JAMA Oncology [American Medical Association]
卷期号:9 (3): 355-355 被引量:24
标识
DOI:10.1001/jamaoncol.2022.6116
摘要

Rectal cancer management has significantly evolved over the last 2 decades.This study aimed to evaluate trends in the characteristics, treatment, and outcomes of rectal adenocarcinoma across 16 years.This retrospective, observational case series study used data from the National Cancer Database (NCDB) to evaluate patients diagnosed with rectal adenocarcinoma from 2004 through 2019. Data analysis was performed from March to May 2022.Trends in the treatment and outcomes of rectal adenocarcinoma in the US between 2004 and 2019 were explored. This period was subdivided into 4 equal periods: 2004-2007, 2008-2011, 2012-2015, and 2016-2019.Patient and tumor characteristics, treatments, short-term outcomes, and overall survival.A total of 318 548 patients diagnosed with rectal adenocarcinoma were included in the analysis, 191 369 (60.1%) of whom were males and 127 179 (39.9%%) were females. The mean (SD) age of the patients was 63.5 (13.4) years, and 46 824 patients (14.8%) were younger than 50 years. Among the patients, 10 859 (3.4%) were of Asian race and ethnicity, 28 464 (8.9%) were Black, and 271 236 (85.1%) were White. The percentage of patients younger than 50 years who were diagnosed with rectal cancer increased by 1.5%, from 13.9% in period 1 to 15.4% in period 4. Patients in the last period (2016-2019) presented more often with stages III (36.2% vs 30.2% vs 25.0% vs 23.4%; P < .001) and IV (21.5% vs 19.3% vs 18.1% vs 18.6%; P < .001) disease compared with those in the remaining 3 periods. The use of chemotherapy (36.8% vs 48.1% vs 49.1% vs 47.0%; P < .001) and immunotherapy (0.4% vs 0.2% vs 3.5% vs 6.5%; P < .001) significantly increased across the 4 periods. Although neoadjuvant radiotherapy was used more often across the periods studied (28.6% in period 1 to 34.3% in period 4), the use of adjuvant radiotherapy was reduced by half (12.9% to 6.0%). The median (IQR) time from diagnosis to definitive surgery increased from 95 (15-126) days in period 1 to 128 (47-158) days in period 4. The rate of use of open surgery decreased by half (60.1% in period 2 to 30.1% in period 4), and the use of robotic surgery significantly increased (5.2% in period 2 to 28.4% in period 4). The conversion rate was significantly reduced (11.2% in period 2 to 7.3% in period 4) and the median (IQR) hospital stay decreased by 2 days, from 6 (3-9) days to 4 (2-7) days. The median (IQR) overall survival significantly increased across the periods (from 83.1 months [95% CI, 81.8-84.6 months] in period 1 to 92.1 months [95% CI, 90.2-93.6 months] in period 3; P < .001).The findings of this case series study suggest a treatment trend of increased use of chemotherapy, immunotherapy, sphincter-saving surgery, and minimally invasive surgery. In addition, the time between diagnosis and definitive surgery increased by a median of 33 days. This treatment trend was associated with a significant improvement in the overall survival, reduction in the conversion rate by 3.9%, and a 2-day shorter hospital stay. These findings have major clinical relevance to the management of rectal cancer. The improvements seen in short-term outcomes and survival of patients diagnosed with rectal cancer can probably be attributed to the treatment trends observed. Continued improvement in outcomes warrant further updates in treatments.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
KYRIAL发布了新的文献求助10
刚刚
1秒前
哩哩发布了新的文献求助10
2秒前
sa发布了新的文献求助10
4秒前
彩色青雪完成签到 ,获得积分10
5秒前
壮观以松发布了新的文献求助10
6秒前
一二三发布了新的文献求助10
6秒前
微笑泥猴桃完成签到,获得积分10
8秒前
ding应助sa采纳,获得10
10秒前
一年发3篇JACS完成签到,获得积分10
11秒前
12秒前
13秒前
14秒前
田様应助kangkirk采纳,获得10
16秒前
Singularity发布了新的文献求助10
17秒前
19秒前
动听千风发布了新的文献求助10
21秒前
刘英坤发布了新的文献求助10
22秒前
sxy应助科研通管家采纳,获得10
22秒前
酷波er应助科研通管家采纳,获得10
22秒前
ww完成签到,获得积分10
22秒前
dengqr5完成签到,获得积分10
23秒前
烟花应助科研通管家采纳,获得30
23秒前
彭于晏应助科研通管家采纳,获得10
23秒前
共享精神应助科研通管家采纳,获得10
23秒前
大模型应助科研通管家采纳,获得10
23秒前
wy.he应助科研通管家采纳,获得10
23秒前
赘婿应助科研通管家采纳,获得10
24秒前
科研通AI2S应助科研通管家采纳,获得10
24秒前
24秒前
隐形曼青应助科研通管家采纳,获得10
24秒前
orixero应助科研通管家采纳,获得10
24秒前
慕青应助科研通管家采纳,获得10
24秒前
英姑应助科研通管家采纳,获得10
24秒前
田様应助科研通管家采纳,获得10
25秒前
852应助科研通管家采纳,获得10
25秒前
无花果应助科研通管家采纳,获得10
25秒前
KWang应助科研通管家采纳,获得10
25秒前
今后应助科研通管家采纳,获得10
25秒前
25秒前
高分求助中
Sustainability in Tides Chemistry 1500
TM 5-855-1(Fundamentals of protective design for conventional weapons) 1000
CLSI EP47 Evaluation of Reagent Carryover Effects on Test Results, 1st Edition 800
Threaded Harmony: A Sustainable Approach to Fashion 799
Livre et militantisme : La Cité éditeur 1958-1967 500
Retention of title in secured transactions law from a creditor's perspective: A comparative analysis of selected (non-)functional approaches 500
"Sixth plenary session of the Eighth Central Committee of the Communist Party of China" 400
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3055748
求助须知:如何正确求助?哪些是违规求助? 2712398
关于积分的说明 7431409
捐赠科研通 2357400
什么是DOI,文献DOI怎么找? 1248780
科研通“疑难数据库(出版商)”最低求助积分说明 606786
版权声明 596163