Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis
Abstract Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare, with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Betwee...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-020-07771-8 |
| _version_ | 1818866151827963904 |
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| author | Yun Xu Cong Li Charlie Zhi-Lin Zheng Yu-Qin Zhang Tian-An Guo Fang-Qi Liu Ye Xu |
| author_facet | Yun Xu Cong Li Charlie Zhi-Lin Zheng Yu-Qin Zhang Tian-An Guo Fang-Qi Liu Ye Xu |
| author_sort | Yun Xu |
| collection | DOAJ |
| description | Abstract Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare, with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Between June 2008 and September 2018, a total of 47 patients were diagnosed with LS by genetic testing at Fudan University Shanghai Cancer Center. A 1:2 propensity score matching was performed to obtain homogeneous cohorts from SCRC group. Thereafter, 94 SCRC patients were enrolled as control group. All of enrolled patients received curative surgeries and standardized postoperative monitoring. The long-term survival rates between the two groups were compared, and the prognostic factors were also analyzed. Results The 5-year overall survival rate of LS group was 97.6%, which was significantly higher than of 82.6% for SCRC group (χ2 = 4.745, p = 0.029). The 5-year recurrence free survival rate showed no significant differences between the two groups (78.0% for LS group vs. 70.6% for SCRC patients; χ2 = 1.260, p = 0.262). The 5-year tumor free survival rates in LS group was 62.1% for LS patients, which were significantly lower than of 70.6% for SCRC group (χ2 = 4.258, p = 0.039). Subgroup analysis of recurrent patients show that the LS group had longer overall survival than the SCRC group after combined chemotherapy. By multivariate analysis, we found that tumor recurrence of primary CRC [Risk ratio (95% (confidence interval): 48.917(9.866–242.539); p < 0.001] and late TNM staging [Risk ratio (95% (confidence interval): 2.968(1.478–5.964); p = 0.002] were independent risk factors for OS. Conclusion LS patients have better long-term survival prognosis than SCRC patients, even though the two groups have statistically comparable recurrence free survival. Combined chemotherapy is an effective treatment for LS patients who developed primary CRC recurrence. Standardized postoperative monitoring for LS patients may enable detection of metachronous tumors at earlier stages, which was a guarantee of a favorable prognosis despite lower tumor free survival. |
| first_indexed | 2024-12-19T10:58:53Z |
| format | Article |
| id | doaj.art-8ddc866029fc4ef1a1b928671568ac85 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-19T10:58:53Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-8ddc866029fc4ef1a1b928671568ac852022-12-21T20:24:43ZengBMCBMC Cancer1471-24072021-01-0121111310.1186/s12885-020-07771-8Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysisYun Xu0Cong Li1Charlie Zhi-Lin Zheng2Yu-Qin Zhang3Tian-An Guo4Fang-Qi Liu5Ye Xu6Department of Colorectal Surgery, Fudan University Shanghai Cancer CenterDepartment of Colorectal Surgery, Fudan University Shanghai Cancer CenterMechanical and Aerospace Engineering, University of CaliforniaDepartment of Oncology, Shanghai Medical College, Fudan UniversityDepartment of Oncology, Shanghai Medical College, Fudan UniversityDepartment of Colorectal Surgery, Fudan University Shanghai Cancer CenterDepartment of Colorectal Surgery, Fudan University Shanghai Cancer CenterAbstract Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare, with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Between June 2008 and September 2018, a total of 47 patients were diagnosed with LS by genetic testing at Fudan University Shanghai Cancer Center. A 1:2 propensity score matching was performed to obtain homogeneous cohorts from SCRC group. Thereafter, 94 SCRC patients were enrolled as control group. All of enrolled patients received curative surgeries and standardized postoperative monitoring. The long-term survival rates between the two groups were compared, and the prognostic factors were also analyzed. Results The 5-year overall survival rate of LS group was 97.6%, which was significantly higher than of 82.6% for SCRC group (χ2 = 4.745, p = 0.029). The 5-year recurrence free survival rate showed no significant differences between the two groups (78.0% for LS group vs. 70.6% for SCRC patients; χ2 = 1.260, p = 0.262). The 5-year tumor free survival rates in LS group was 62.1% for LS patients, which were significantly lower than of 70.6% for SCRC group (χ2 = 4.258, p = 0.039). Subgroup analysis of recurrent patients show that the LS group had longer overall survival than the SCRC group after combined chemotherapy. By multivariate analysis, we found that tumor recurrence of primary CRC [Risk ratio (95% (confidence interval): 48.917(9.866–242.539); p < 0.001] and late TNM staging [Risk ratio (95% (confidence interval): 2.968(1.478–5.964); p = 0.002] were independent risk factors for OS. Conclusion LS patients have better long-term survival prognosis than SCRC patients, even though the two groups have statistically comparable recurrence free survival. Combined chemotherapy is an effective treatment for LS patients who developed primary CRC recurrence. Standardized postoperative monitoring for LS patients may enable detection of metachronous tumors at earlier stages, which was a guarantee of a favorable prognosis despite lower tumor free survival.https://doi.org/10.1186/s12885-020-07771-8Colorectal cancerLynch syndromeMismatch repairSurvivalChemotherapy |
| spellingShingle | Yun Xu Cong Li Charlie Zhi-Lin Zheng Yu-Qin Zhang Tian-An Guo Fang-Qi Liu Ye Xu Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis BMC Cancer Colorectal cancer Lynch syndrome Mismatch repair Survival Chemotherapy |
| title | Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis |
| title_full | Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis |
| title_fullStr | Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis |
| title_full_unstemmed | Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis |
| title_short | Comparison of long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis |
| title_sort | comparison of long term outcomes between lynch sydrome and sporadic colorectal cancer a propensity score matching analysis |
| topic | Colorectal cancer Lynch syndrome Mismatch repair Survival Chemotherapy |
| url | https://doi.org/10.1186/s12885-020-07771-8 |
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