, Volume 24, Issue 11, pp 1249-1254
Date: 21 Jul 2009

The impact of family history on the outcome of patients with colorectal cancer in a veterans’ hospital

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Abstract

Purpose

The purpose of the study was to investigate the impact of a family history (FH) of colorectal cancer (CRC) in first-degree relatives on the outcome of patients with CRC in a veterans’ hospital in Taiwan.

Methods

Patients (N= 3,383) with colorectal adenocarcinoma were studied; pedigrees were collected prospectively. Associations between FH and clinicopathologic variables were analyzed using linear-by-linear association. Survival was examined with Kaplan–Meier curves and the log-rank test.

Results

Two hundred ninety-seven patients (8.78%) had a first-degree relative with CRC. The average age of onset of CRC was 68.3 years in patients without a FH. This was significantly higher than the age of onset in patients with a FH (66.4 years—one first-degree relative with CRC; 48.8 years—two or more first-degree relatives, P < 0.001). Patients with more affected family members had a higher incidence of right-sided tumor (P = 0.004), metachronous cancer (P = 0.034), and less-advanced disease (P = 0.044). The 5-year overall survival was 83% for patients with two or more first-degree relatives with CRC, 57% for those with one first-degree relative, and 55% for those without a FH (P = 0.001). The 5-year DFS was 91% for patients with two or more first-degree relatives, 66% for those with one first-degree relative, and 64% for those without a FH of CRC (P = 0.002). In the multivariate analysis, TNM stage played the most independent prognostic factor, followed by FH (P < 0.001, hazard ratio = 1.52; 95% confidence interval, 1.24–1.85).

Conclusions

CRC patients with a family history of CRC had better survival than did those without a family history of CRC.