Characteristics affecting survival after locally advanced XXXX in Quebec.

@entity1 @entity5 @entity694 @entity14 @entity204
BACKGROUND: We estimated the relations of sociodemographic, organizational, disease, and treatment variables with the risk of @entity204 from @entity14 ( @entity14 ) in a Quebec population-based sample of @entity1 with locally advanced @entity14 (lacrc) who underwent @entity5 resection with curative intent. METHODS: Information from medical records and administrative databases was obtained for a random sample of 633 @entity1 surgically treated for stages ii-iii rectal and stage iii @entity694 and @entity5 registry in 1998 and 2003. We measured personal, disease, and clinical management characteristics, relative survival, and through multivariate modelling, relative excess rate (rer) of @entity204 . RESULTS: The relative 5- and 10-year survivals in this cohort were 67.7% [95% confidence interval (ci): 65.8% to 69.6%] and 61.2% (95% ci: 58.3% to 64.0%) respectively. Stage T4, stage N2, and emergency rather than elective surgery affected 18%, 24% and 10% of @entity1 respectively. Those disease progression characteristics each independently increased the rer of @entity204 by factors of 2 to almost 5. Grade, vascular invasion, and @entity5 location were also significantly associated with the rer for @entity204 . Receiving guideline-adherent treatment was associated with a 60% reduction in the rer for @entity204 (0.41; 95% ci: 0.28 to 0.61), an effect that was consistent across age groups. Clear margins (proximal-distal, radial) and clinical trial enrolment were each associated with a nonsignificant 50% reduction in the rer. Of @entity1 less than 70 years of age and 70 years of age and older, 81.3% and 42.0% respectively received guideline-adherent treatment. CONCLUSIONS: This study is the first Quebec population-based examination of @entity1 with lacrc and their management, outcomes, and outcome determinants. The results can help in planning @entity14 control strategies at a population level.
