Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer

A propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes

Ryo Inada, Takeshi Nagasaka, Ayako Watanabe, Tomohiko Yagi, Yoshiko Mori, Yoshitaka Kondo, Hiroyuki Kishimoto, Yuzo Umeda, Toshiyoshi Fujiwara

Research output: Contribution to journalArticle

Abstract

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 PSmatched 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.

Original languageEnglish
Article numbere000146
JournalBMJ Open Gastroenterology
Volume4
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

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Propensity Score
Colorectal Neoplasms
Costs and Cost Analysis
Postoperative Hemorrhage
Colorectal Surgery
Minimally Invasive Surgical Procedures
Early Detection of Cancer
Sample Size
Length of Stay
Neoplasms
Cohort Studies
Survival

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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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",
abstract = "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 PSmatched 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.",
author = "Ryo Inada and Takeshi Nagasaka and Ayako Watanabe and Tomohiko Yagi and Yoshiko Mori and Yoshitaka Kondo and Hiroyuki Kishimoto and Yuzo Umeda and Toshiyoshi Fujiwara",
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T1 - Comparison of outcomes between symptomatic and asymptomatic patients with colorectal cancer

T2 - A propensity score-matched analysis of surgical invasiveness, medical costs and oncological outcomes

AU - Inada, Ryo

AU - Nagasaka, Takeshi

AU - Watanabe, Ayako

AU - Yagi, Tomohiko

AU - Mori, Yoshiko

AU - Kondo, Yoshitaka

AU - Kishimoto, Hiroyuki

AU - Umeda, Yuzo

AU - Fujiwara, Toshiyoshi

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N2 - 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 PSmatched 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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