Ji Ho Yoon, Yoon Yung Park, Jeonghee Han, Byung Soh Min, Kang Young Lee, Nam Kyu Kim. Yonsei University, College of Medicine
Purpose: Colorectal cancer appears to have rapidly increased over the past two decades in some Asian countries, including Taiwan, Japan, and Republic of Korea. Therefore, it may be significant that we review the change of treatment paradigm for colorectal cancer and its improved treatment results.
Method: Patients with biopsy proven colon adenocarcinoma who underwent colon surgery between Jan 2000 and Dec 2012 were enrolled. The medical records of total 2606 patients were reviewed. The study period was divided into three intervals (P1: 2000-2004; P2: 2005-2008; P3: 2009-2012). Clinicopathological factors were examined included age, sex, BMI, ASA score, operation methods, surgical complication, tumor location, TNM stage, grading of tumor, lymphovascular invasion, tumor size, tumor gross morphology, preoperative CEA level, recurrence pattern, hospital stay, total treatment costs and adjuvant chemotherpapy regimens. We analyze survival according to periods and stage
Results: Tumor location was changed from right side to left side. The significant difference was shown in left side increasingly according to period (46.8%, 53.7%, 54.1%, p = 0.018). According to period, operation method was changed from open to MIS. MIS became main operation in period 3 (24.0%, 43.6%, 74.3%, p < 0.001). Stage ? increased (12.7%, 16.6%, 39.6%, p < 0.001), but stage ? decreased according to period (38.7%, 34.7%, 16.8%, p < 0.001). Hospital stay was shorter according to period (19.0[15.0; 23.0], 17.0[14.0; 22.0], 12.0[9.0; 16.0], p < 0.001). Total cost of treatment increased from P1 to P3 ($6224.0[5336.0; 7831.0], $8448.0[7105.5; 10409.5], $8932.0[7814.0; 10790.0], p < 0.001). Treatment of oxaliplatin in stage ? was increased according to period (0.8%, 61.9%, 75.8%, p < 0.001), but use of leucovorin in stage ? was decreased (78.4%, 18.5%, 0.7%, p < 0.001). The surgical complication was less in P3 (2.4%, p = 0.02). Recurrence rate in P3 is lower than others (24.4%, 23.9%, 16.6%, p < 0.001). No significant difference was observed in disease free survival (78.8% vs 77.7% vs 85.0%, p = 0.059) according to period. Otherwise, significant difference in overall survival (68.2% vs 78.9% vs 89.1%, p = 0.036) was observed among the period. In addition, overall survival in P1 was poorer than the others in stage ? (56.0% vs 77.2% vs 77.1%, p = 0.009).
Conclusion: Our study demonstrates the trend of colon cancer in Korea for over the past 10 years. Early diagnosis, development of surgical technique and newer agent led to improved survival in colon cancer in Korea.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77683
Program Number: P261
Presentation Session: Poster (Non CME)
Presentation Type: Poster
