ABSTRACT Objective: To determine 5-year survival in patients with colorectal cancer (CRC) according to patient and tumor characteristics. Methods: Longitudinal study based on incident cases of invasive CRC between 2008 and 2017 captured by the Manizales Population-based Cancer Registry (n=850). Patients were followed up to August 24th, 2021. Cause-specific survival and net survival were calculated for sociodemographic and tumor characteristics, and Cox multivariate was fitted. Results: Fifty-five percent of cases occurred in women. The most frequent histological type was adenocarcinoma (78.2%). The most frequent locations were rectum (32.0%), ascending colon (16.6%), and sigmoid (16.2%). Twenty-five percent of cases were diagnosed in stage IV. There were 567 deaths due to CRC. The 5-year specific survival was 45.8% (95%CI 42.4–49.3), with independent effects for age (HR=1.83; 95%CI 1.26–2.65 age >75 years vs. <50 years) and advanced clinical stage (HR=2.5 and HR 5.7 for stages III and IV vs. stage I, respectively). Lower survival was observed in patients of medium socioeconomic status compared with higher socioeconomic status (HR=1.52; 95%CI 1.08–2.14), but not in patients of low socioeconomic status. No independent effects were observed for the health insurance regime. Conclusions: In Manizales, approximately 5 out of 10 patients with invasive CRC die in the first five years after diagnosis, with a lower survival in patients older than 75 years, from medium socioeconomic level and diagnosed in advanced clinical stages. Objective 5year year (CRC characteristics Methods 200 201 Populationbased Population n=850. n850 n n=850 . 850 (n=850) 24th th 2021 Causespecific Cause fitted Results Fiftyfive Fifty women 78.2%. 782 78.2% 78 2 (78.2%) 32.0%, 320 32.0% , 32 0 (32.0%) 16.6%, 166 16.6% 16 6 (16.6%) 16.2%. 162 16.2% (16.2%) Twentyfive Twenty 56 458 45 8 45.8 95CI CI 95 42.4–49.3, 424493 42.4–49.3 42 4 49 3 42.4–49.3) HR=1.83 HR183 1 83 (HR=1.83 126265 26 65 1.26–2.6 >7 vs 50 <5 HR=2.5 HR25 (HR=2. 57 7 5. I respectively. respectively respectively) HR=1.52 HR152 52 (HR=1.52 1.08–2.14, 108214 1.08–2.14 08 14 1.08–2.14) regime Conclusions diagnosis 20 n85 n=85 85 (n=850 202 78.2 (78.2% 32.0 (32.0% 16.6 (16.6% 16.2 (16.2% 45. 9 42449 42.4–49. HR=1.8 HR18 (HR=1.8 12626 1.26–2. > < HR=2. HR2 (HR=2 HR=1.5 HR15 (HR=1.5 10821 1.08–2.1 n8 n=8 (n=85 78. (78.2 32. (32.0 16. (16.6 (16.2 4244 42.4–49 HR=1. HR1 (HR=1. 1262 1.26–2 HR=2 (HR= 1082 1.08–2. n= (n=8 (78. (32. (16. 424 42.4–4 HR=1 (HR=1 126 1.26– HR= (HR 108 1.08–2 (n= (78 (32 (16 42.4– 12 1.26 1.08– (n (7 (3 (1 42.4 1.2 1.08 ( 42. 1. 1.0
RESUMEN Objetivo: Estimar la supervivencia a 5 años en pacientes con cáncer colorrectal (CCR) según características del paciente y del tumor. Métodos: Estudio longitudinal a partir de los casos de CCR invasivo diagnosticados entre 2008 y 2017 captados por el Registro Poblacional de Cáncer de Manizales (n=850). Se realizó seguimiento hasta el 24 de agosto de 2021. Se calculó la supervivencia causa-específica y la supervivencia neta para las características sociodemográficas y del tumor, y análisis multivariado de Cox. Resultados: El 55,5% de los casos se presentaron en mujeres. El tipo histológico más frecuente (78,2%) fue el adenocarcinoma. Las localizaciones más frecuentes fueron recto (32,0%), colon ascendente (16,6%) y sigmoides (16,2%). El 25,5% de los casos fue diagnosticado en estadio IV. Ocurrieron 567 muertes por CCR. La supervivencia específica a 5 años fue del 45,8% (IC95% 42,4–49,3), con efectos independientes para la edad (HR=1,83; IC95% 1,26–2,65 edad >75 años vs. edad <50 años) y el estadio clínico avanzado (HR=2,5 y HR 5,7 para estadios III y IV vs. estadio I). Se observó una menor supervivencia en pacientes de nivel socioeconómico medio en comparación con el grupo de mayor posición socioeconómica (HR=1,52; IC95% 1,08–2,14), pero no en los pacientes de posición socioeconómica baja. No se observaron efectos independientes para el régimen de aseguramiento en salud. Conclusiones: En Manizales, aproximadamente 5 de cada 10 pacientes con CCR invasivo fallecen en los primeros cinco años del diagnóstico, con sobrevida menor en pacientes mayores de 75 años, de nivel socioeconómico medio y diagnosticados en estadio clínico avanzado. Objetivo (CCR tumor Métodos 200 201 n=850. n850 n n=850 . 850 (n=850) 2 2021 causaespecífica causa Cox Resultados 555 55 55,5 mujeres 78,2% 782 78 (78,2% adenocarcinoma 32,0%, 320 32,0% , 32 0 (32,0%) 16,6% 166 16 6 (16,6% 16,2%. 162 16,2% (16,2%) 255 25 25,5 56 458 45 8 45,8 IC95 IC (IC95 42,4–49,3, 424493 42,4–49,3 42 4 49 3 42,4–49,3) HR=1,83 HR183 1 83 (HR=1,83 126265 26 65 1,26–2,6 >7 vs 50 <5 HR=2,5 HR25 (HR=2, 57 7 5, I. I I) HR=1,52 HR152 52 (HR=1,52 1,08–2,14, 108214 1,08–2,14 08 14 1,08–2,14) baja salud Conclusiones diagnóstico 20 n85 n=85 85 (n=850 202 55, 78,2 (78,2 32,0 (32,0% 16,6 (16,6 16,2 (16,2% 25, 45, IC9 (IC9 42449 42,4–49, HR=1,8 HR18 (HR=1,8 12626 1,26–2, > < HR=2, HR2 (HR=2 HR=1,5 HR15 (HR=1,5 10821 1,08–2,1 n8 n=8 (n=85 78, (78, 32, (32,0 16, (16, (16,2 (IC 4244 42,4–49 HR=1, HR1 (HR=1, 1262 1,26–2 HR=2 (HR= 1082 1,08–2, n= (n=8 (78 (32, (16 424 42,4–4 HR=1 (HR=1 126 1,26– HR= (HR 108 1,08–2 (n= (7 (32 (1 42,4– 12 1,26 1,08– (n ( (3 42,4 1,2 1,08 42, 1, 1,0