More Favorable Short and Long-Term Outcomes for Screen-Detected Colorectal Cancer Patients

Frontiers in Oncology

Daniela Prando¹  Ferdinando Agresta¹  Massimo Rugge²  Salvatore Pucciarelli³  Giulia Capelli³  Gaya Spolverato³  Andrea Barina³  Alessandro Perin³  Corrado Pedrazzani⁴  Giulia Turri⁴  Josè Adolfo Navarro⁵  Emilio Morpurgo⁵  Isabella Mondi⁶  Corrado Da Lio⁶  Susi Nordio⁷  Elena Finotti⁷  Fabio Ceccato⁸  Marco Massani⁹  Adriana Di Giacomo⁹  Michela Campi^1,10  Giacomo Zanus^1,10  Jessica Battagello^1,11  Manuel Zorzi^1,11 

[1] 0Department of General Surgery, Adria Civil Hospital, Adria, Italy;1Department of Medicine DIMED, Pathology and Cytopathology Unit, University of Padova, Padova, Italy;Department Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy;Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy;General Surgery Unit, Camposampiero Hospital, Camposampiero, Italy;General Surgery Unit, Mirano Hospital, Mirano, Italy;General Surgery Unit, “SS. Giovanni e Paolo” Hospital, Venezia, Italy;General Surgery Unit, “Sant’Antonio” Hospital, Padova, Italy;III Surgical Unit, Ca’ Foncello Hospital, Treviso, Italy;IV Surgical Unit, Ca’ Foncello Hospital, Treviso, Italy;Veneto Tumor Registry, Azienda Zero, Padova, Italy;

关键词: colorectal cancer;    surgery;    screening;    colorectal cancer outcomes;    disease free survival;    overall survival;   

DOI  :  10.3389/fonc.2021.620644

来源: DOAJ

【 摘 要 】

BackgroundScreening significantly reduces mortality from colorectal cancer (CRC). Screen detected (SD) tumors associate with better prognosis, even at later stage, compared to non-screen detected (NSD) tumors. We aimed to evaluate the association between diagnostic modality (SD vs. NSD) and short- and long-term outcomes of patients undergoing surgery for CRC.Materials and MethodsThis retrospective cohort study involved patients aged 50–69 years, residing in Veneto, Italy, who underwent curative-intent surgery for CRC between 2006 and 2018. The clinical multi-institutional dataset was linked with the screening dataset in order to define diagnostic modality (SD vs. NSD). Short- and long-term outcomes were compared between the two groups.ResultsOf 1,360 patients included, 464 were SD (34.1%) and 896 NSD (65.9%). Patients with a SD CRC were more likely to have less comorbidities (p = 0.013), lower ASA score (p = 0.001), tumors located in the proximal colon (p = 0.0018) and earlier stage at diagnosis (p < 0.0001). NSD patients were found to have more aggressive disease at diagnosis, higher complication rate and higher readmission rate due to surgical complications (all p < 0.05). NSD patients had a significantly lower Disease Free Survival and Overall Survival (all p < 0.0001), even after adjusting by demographic, clinic-pathological, tumor, and treatment characteristics.ConclusionsSD tumors were associated with better long-term outcomes, even after multiple adjustments. Our results confirm the advantages for the target population to participate in the screening programs and comply with their therapeutic pathways.

【 授权许可】

Unknown