Ann Surg Oncol. 2019 Jan 25. doi: 10.1245/s10434-019-07179-0. [Epub ahead of print]
Impact of Family History on Prognosis of Patients with Sporadic Colorectal Cancer.
A family history (FH) of colorectal cancer (CRC) increases the risk for development of CRC, but the impact of FH of CRC on survival from sporadic CRC is unclear. This study investigated the prognostic impact of FH of CRC on the recurrence and survival of patients with sporadic CRC.
We reviewed the records of patients with sporadic CRC from two tertiary referral hospitals in Korea who underwent surgical resection between May 2007 and September 2013. The clinicopathologic features and oncologic outcomes of those with and without FHs of CRC were compared.
We examined the records of 2960 eligible patients, 163 (5.5%) of whom had first-degree relatives with CRC. Patients with and without FHs of CRC had similar baseline characteristics. Multivariable analysis indicated that a FH of CRC was not significantly associated with disease-free survival but was significantly associated with better overall survival (OS) [adjusted hazard ratio = 0.539, 95% confidence interval (CI) 0.330-0.881, P = 0.014]. Subgroup analysis indicated that females and rectal cancer patients with FHs of CRC had significantly better prognoses. Microsatellite status did not affect the improved survival rate associated with FH.
This study of patients with sporadic CRC indicated that those who had FHs of CRC had better OS but similar cancer recurrence as those who had no FH of CRC. The effect of FH of CRC on OS was independent of microsatellite status. Further studies are needed to identify underlying mechanisms and determine the optimal clinical management of CRC according to FH.