Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7183
Revised: September 15, 2013
Accepted: September 16, 2013
Published online: November 7, 2013
AIM: To compare the clinical factors and tumor characteristics that predict survival in colorectal cancer (CRC) patients with different ethnicities in Xin Jiang area.
METHODS: A total of 1421 histopathologically confirmed sporadic CRC patients who were either Han/Chinese or Uyghur were identified and enrolled from a database of both diagnoses and operative procedures from Xin Jiang Tumor Hospital, which is affiliated to Xin Jiang Medical University between 2000 and 2007. Patients with family histories of CRC, hereditary nonpolyposis CRC, familial adenomatous polyposis, inflammatory bowel disease, carcinoid, squamous carcinoma or melanoma were excluded. The two ethnic groups were compared with regard to clinical features, tumor characteristics, disease stage, overall survival rate, disease-free survival rate and cancer-specific survival rate. The factors predicting long-term survival were assessed via both univariate and multivariate analysis.
RESULTS: Among the 1421 patients with CRC enrolled in this study, 1210 patients were Han/Chinese (mean age, 62.3 ± 4.5 years; range, 19-92 years), while 211 patients were Uyghur (mean age, 52.4 ± 15.6 years; range, 17-87 years). There were significant differences in proportions of gender, age, blood type, occupation and histopathological type between the Han/Chinese and Uyghur patients (P < 0.05). The median overall, disease-free and cancer-specific survival time were 45, 62 and 65 mo for the Han/Chinese patients and 42, 49 and 61 mo for the Uyghur patients (P = 0.000, P = 0.005, P = 0.007). The cumulative 5-year survival of the Uyghur patients was significantly worse than that of the Han patients (P = 0.000). A multivariate analysis showed that age, ethnicity, histopathological type, differentiation, T (Infiltration depth), N (Lymph node metastasis), staging, postoperative metastasis and metastatic site (P < 0.05) were found to be the prognostic factors.
CONCLUSION: The Uyghur CRC patients are associated with significantly younger age, more aggressive histopathologic characteristics and have significantly worse prognosis than the Han/Chinese patients.
Core tip: Racial/ethnic differences in colorectal cancer (CRC) survival have been documented in the literatures. However, the reasons for these disparities are difficult to decipher. These disparities may be attributed to many factors, including differences in socioeconomic status, tumor biology, stage at diagnosis, treatment, post-treatment surveillance, physician characteristics and hospital factors. This is the first comparative study on the clinicopathological factors and survival of CRC patients with different ethnicities in Xin Jiang. We found some marked differences and performed preliminary analysis for possible reasons.