Family history of colorectal cancer (CRC) in first degree relatives and survival in patients with newly diagnosed synchronous metastatic CRC

Background

Colorectal cancer (CRC) history in first degree relative is a known risk factor for CRC and correlates with better survival in patients with early stage CRC. However, the prognostic effect of CRC history in first degree relatives (CHFR) in newly diagnosed synchronous metastatic CRC is not well known. The current study aims to determine prognostic roles of CHFR in patients with newly diagnose metastatic CRC.

Methods

A cohort of patients diagnosed with synchronous stage IV CRC during 2006-2010 in the province of Saskatchewan was studied. Patients who did not have information about family history (FH) were excluded. A Cox proportional multivariate analysis was performed to assess relationship between CHFR and survival.

Results

419 eligible patients with synchronous stage IV CRC were identified, 342 (81.6%) had a positive FH whereas 77 (18.4%) did not have a FH of cancer. Of 342 patients with a positive FH, 106 (30.9%) had a FH of CRC and 76 (22.2%) had CHFR (father, n = 21, mother, n = 15, brother, n = 20, sister, n = 15, son n = 3, daughter, n = 2). Of 76 patients with CHFR, 69 had one, 6 had 2, and one had 3 first degree relative with the diagnosis of CRC. Thirteen (12%) of 106 patients also had a diagnosis of CRC in a grandparent. Median overall survival of patients with CHFR who received chemotherapy was 17 months (95% CI: 13.9-20.1) compared with 22 months (19.1-24.9) if they don't have CHFR (p = 0.10). The Cox proportional multivariate model revealed following relationship between various variables and survival. Use of chemotherapy, HR: 0.30 (0.22-0.39), metastasectomy, HR: 0.41 (95% CI: 0.29-0.57), age 

Conclusions

Unlike early stage CRC, CHFR does not correlate with better survival in patients with newly diagnosed synchronous stage IV CRC. In fact, we noted a trend toward inferior survival in patients with CHFR.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

Saskatchewan Cancer Agency

Disclosure

All authors have declared no conflicts of interest.