Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 7, 2013; 19(41): 7183-7188
Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7183
Clinical features and prognosis in colorectal cancer patients with different ethnicities in Northwest China
Akram Yusup, Hai-Jiang Wang, Azmat Rahmutula, Parhat Sayim, Ze-Liang Zhao, Guo-Qing Zhang
Akram Yusup, Hai-Jiang Wang, Azmat Rahmutula, Parhat Sayim, Ze-Liang Zhao, Guo-Qing Zhang, Department of Gastrointestinal Surgery, Xin Jiang Tumor Hospital, Xin Jiang Medical University, Urumqi 830011, Xinjiang Uighur Autonomous Region, China
Author contributions: Yusup A was responsible for the conception and drafting of the paper; Zhang GQ gave the final approval and supervised the paper; Wang HJ critically reviewed and revised the paper; Rahmutula A and Sayim P collected source material and analyzed preliminary data; Zhao ZL analyzed the data and performed the statistics.
Correspondence to: Guo-Qing Zhang, MD, Department of Gastrointestinal Surgery, Xin Jiang Tumor Hospital, Xin Jiang Medical University, 789 East Su Zhou Road Urumqi 830011, Xinjiang Uighur Autonomous Region, China. bilik0731@163.com
Telephone: +86-991-7819102 Fax: +86-991-7968111
Received: May 24, 2013
Revised: September 15, 2013
Accepted: September 16, 2013
Published online: November 7, 2013
Processing time: 175 Days and 20.8 Hours
Abstract

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.

Keywords: Colorectal cancer; Ethnicity; Clinicopathological factor; Survival

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.