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Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes

BACKGROUND AND AIMS: Whether asymptomatic patients with colorectal cancer (CRC) who are treated in hospitals show better outcomes than symptomatic patients with CRC still remains unknown. The aim of this study was to evaluate differences in clinical benefits following treatment in asymptomatic and s...

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Autores principales: Inada, Ryo, Nagasaka, Takeshi, Watanabe, Ayako, Yagi, Tomohiko, Mori, Yoshiko, Kondo, Yoshitaka, Kishimoto, Hiroyuki, Umeda, Yuzo, Fujiwara, Toshiyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609081/
https://www.ncbi.nlm.nih.gov/pubmed/28944068
http://dx.doi.org/10.1136/bmjgast-2017-000146
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author Inada, Ryo
Nagasaka, Takeshi
Watanabe, Ayako
Yagi, Tomohiko
Mori, Yoshiko
Kondo, Yoshitaka
Kishimoto, Hiroyuki
Umeda, Yuzo
Fujiwara, Toshiyoshi
author_facet Inada, Ryo
Nagasaka, Takeshi
Watanabe, Ayako
Yagi, Tomohiko
Mori, Yoshiko
Kondo, Yoshitaka
Kishimoto, Hiroyuki
Umeda, Yuzo
Fujiwara, Toshiyoshi
author_sort Inada, Ryo
collection PubMed
description BACKGROUND AND AIMS: Whether asymptomatic patients with colorectal cancer (CRC) who are treated in hospitals show better outcomes than symptomatic patients with CRC still remains unknown. The aim of this study was to evaluate differences in clinical benefits following treatment in asymptomatic and symptomatic patients with CRC. METHODS: This study was a retrospective cohort analysis with data obtained from records. A cohort of 145 asymptomatic and 123 symptomatic patients who underwent CRC surgery between January 2009 and December 2011 was enrolled. To reduce bias in comparing outcomes, propensity score (PS) analysis was used for matching of patients in the symptomatic and asymptomatic groups based on clinicopathological factors. Surgical invasiveness, medical costs and oncological outcomes were examined by unadjusted and PS-matched analysis. RESULTS: Tumours in the symptomatic group were more often diagnosed in advanced stages compared with tumours in the asymptomatic group. Therefore, fewer symptomatic group patients underwent minimally invasive surgery. Short-term outcomes, including amount of blood loss, duration of postoperative hospital stay and perioperative medical costs, were significantly better in the asymptomatic group. Although overall survival was significantly better in the asymptomatic group, there was no significant difference between the groups when the patients were adjusted on the basis of PS. CONCLUSIONS: Though this study was limited by the retrospective nature and small sample size, favourable outcomes in asymptomatic patients were due to the higher proportion of patients in this group who were diagnosed with CRC in earlier stages, due to participation in CRC screening programmes.
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spelling pubmed-56090812017-09-22 Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes Inada, Ryo Nagasaka, Takeshi Watanabe, Ayako Yagi, Tomohiko Mori, Yoshiko Kondo, Yoshitaka Kishimoto, Hiroyuki Umeda, Yuzo Fujiwara, Toshiyoshi BMJ Open Gastroenterol Colorectal Cancer BACKGROUND AND AIMS: Whether asymptomatic patients with colorectal cancer (CRC) who are treated in hospitals show better outcomes than symptomatic patients with CRC still remains unknown. The aim of this study was to evaluate differences in clinical benefits following treatment in asymptomatic and symptomatic patients with CRC. METHODS: This study was a retrospective cohort analysis with data obtained from records. A cohort of 145 asymptomatic and 123 symptomatic patients who underwent CRC surgery between January 2009 and December 2011 was enrolled. To reduce bias in comparing outcomes, propensity score (PS) analysis was used for matching of patients in the symptomatic and asymptomatic groups based on clinicopathological factors. Surgical invasiveness, medical costs and oncological outcomes were examined by unadjusted and PS-matched analysis. RESULTS: Tumours in the symptomatic group were more often diagnosed in advanced stages compared with tumours in the asymptomatic group. Therefore, fewer symptomatic group patients underwent minimally invasive surgery. Short-term outcomes, including amount of blood loss, duration of postoperative hospital stay and perioperative medical costs, were significantly better in the asymptomatic group. Although overall survival was significantly better in the asymptomatic group, there was no significant difference between the groups when the patients were adjusted on the basis of PS. CONCLUSIONS: Though this study was limited by the retrospective nature and small sample size, favourable outcomes in asymptomatic patients were due to the higher proportion of patients in this group who were diagnosed with CRC in earlier stages, due to participation in CRC screening programmes. BMJ Publishing Group 2017-07-03 /pmc/articles/PMC5609081/ /pubmed/28944068 http://dx.doi.org/10.1136/bmjgast-2017-000146 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Colorectal Cancer
Inada, Ryo
Nagasaka, Takeshi
Watanabe, Ayako
Yagi, Tomohiko
Mori, Yoshiko
Kondo, Yoshitaka
Kishimoto, Hiroyuki
Umeda, Yuzo
Fujiwara, Toshiyoshi
Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
title Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
title_full Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
title_fullStr Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
title_full_unstemmed Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
title_short Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
title_sort comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer: a propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes
topic Colorectal Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609081/
https://www.ncbi.nlm.nih.gov/pubmed/28944068
http://dx.doi.org/10.1136/bmjgast-2017-000146
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