553P - Age dependent increase in median and long-term survival in 29 628 metastatic colorectal cancer (mCRC) Scandinavian patients during the past two deca...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Cancer Aetiology, Epidemiology, Prevention
Colon Cancer
Rectal Cancer
Presenter Camilla Qvortrup
Authors C. Qvortrup1, M. Cvancarova2, B. Glimelius3, P. Pfeiffer1, H. Sorbye4
  • 1Oncology, Odense University Hospital, 5000 - Odense C/DK
  • 2Dep. Of Biostatistics, Cancer Registry of Norway and University of Oslo, Oslo/NO
  • 3Oncology, Radiology And Clinical Immunology, University Hospital UppsalaAkademiska Sjukhuset, SE-751 85 - Uppsala/SE
  • 4Dep. Of Oncology, Haukeland University Hospital, Bergen/NO

Abstract

Background

In mCRC studies, median survival has increased from 6-8 months to above 20 months during the last decades. Uncertainty exists whether this improvement in survival is also seen in a general mCRC population or in selected subgroups.

Methods

Survival data from patients with synchronous mCRC were collected from Norwegian (1980-2008), Swedish (1996-2008, Uppsala/ Orebro and Stockholm) and Danish (2001-2009) cancer registries. Survival was modeled using Kaplan-Meier method and the differences assessed with log-rank test.

Results

A total of 18 114 Norwegian, 6477 Danish and 5037 Swedish patients were identified. The percentage of stage IV, Norwegian CRC patients at initial diagnosis was 22% and unchanged during the study period. From 1980-85 to 2006-08, median survival increased from 5 months (95% CI 4.7-5.3) to 10 months (95% CI 9.1-10.9) for Norwegian patients. Three-year survival increased from 7% to 21% (p < 0.001) and five-year survival from 4% to 9% (p < 0.001) in the same period. Younger patients had significantly higher median and long-term survival, and the increase in survival in recent years was much higher for younger patients. For age groups <60 years, median survival has doubled from 8 to 16 months and the most recent survival estimates were 14% (5-year) and 28% (3-year). A similar improvement in median survival and 3-year survival was seen in Sweden (8 to 11 months and 11% to 21% (p < 0.001) from 1996-2001 to 2006-2008 and in Denmark (7 to 10 months and 12 to 18% (p < 0.001) from 2001-2005 to 2006-09). No increase in survival was observed in patients above 80 years.

Conclusions

The study shows a marked improvement in median and long-term survival from 1980 to 2008 in an unselected population of patients with synchronous mCRC. We believe this survival benefit mainly reflects increased use of more effective systemic therapy. Median and long-term survival were highly dependent on age at diagnosis, as the recent improvement in survival was most pronounced for younger patients.

Disclosure

P. Pfeiffer: Research funding: Merck and Roche Advisory board: Merck, Roche and Amgen.

H. Sorbye: Research funding Merck, Roche and Amgen.

All other authors have declared no conflicts of interest.