Clinical Characteristics and Disease Outcome of UICC Stages I-III Colorectal Cancer Patients at Siriraj Hospital
Sirisopa Techawathanawanna MD*, Akarin Nimmannit MD**, Charuwan Akewanlop MD*
Affiliation : * Division of Medical Oncology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Office of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Colorectal cancer is the third most common cancer worldwide. There were only a few reports of disease
outcomes in Thai. Therefore, the authors retrospectively reviewed the clinical characteristics and disease outcome of patients
with curable colorectal cancer treated at Siriraj Hospital, the largest tertiary-care hospital in Thailand.
Material and Method: Medical records of colorectal cancer patients diagnosed at Siriraj Hospital between January 2003
and December 2007 were reviewed. The records of the patients presenting with stage I-III and had been follow-up for at least
2 years were explored. Clinical characteristics, including demographic data, primary tumor site, TMN staging, histopathology,
and CEA level were described. Disease outcome including survival, recurrence of disease and complication were analyzed.
Results : One thousand forty-seven colorectal cancer patients were diagnosed and completely staged during the study period.
The incidence of stage I-IV was 9%, 22%, 37% and 32%, respectively. Three hundred fifty-five patients with stage I-III
colorectal cancer were analyzed. The ratio of male and female was 1.4:1. The median age was 59.8 years. Forty-eight percent
and 52% of patients had colon and rectal cancer, respectively. The median follow-up time was 63.3 months. The mean time
from diagnosis to surgery was 23 days. Two hundred forty eight patients (70%) received adjuvant or neoadjuvant chemotherapy
with the majority receiving 5-fluorouracil and leucovorin. 5-year disease free survival rate in stage I-III was 90%, 85% and
58%, respectively and 5-year overall survival in stage I-III was 93%, 93% and 73%, respectively. Independent risk factors
for disease-free survival were gender, preoperative CEA and stage; for overall survival were gender and stage.
Conclusion : Approximately two-thirds (68%) of patients with colorectal cancer at Siriraj hospital presented with a potentially
curable stage. Multi-modality treatments with surgery, adjuvant chemotherapy and radiation resulted in comparable survival
as in Western countries. Independent risk factors for worse survival in this cohort were stage III disease and male gender.
Keywords : Colorectal cancer, Disease outcome, Thailand
