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Variation at presentation among colon cancer patients with metastases: a population-based study
Region Östergötland, Center for Health and Developmental Care, Regional Cancer Center South East Sweden. Palliat Educ and Research Centre, Sweden.
Lanssjukhuset Kalmar, Sweden.
Jonköping County Council, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Regional Cancer Center South East Sweden.
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2015 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 17, no 5, 403-408 p.Article in journal (Refereed) Published
Abstract [en]

AimThe study aimed to describe and follow a 2year cohort of colon cancer patients with Stage IV disease from presentation to long-term outcome. MethodThe records of 177 colon cancer patients diagnosed in southeast Sweden during 2009-2010 with disseminated disease at presentation were reviewed retrospectively. ResultsThe patients were heterogeneous with respect to age, performance status and survival. Despite metastatic disease, local symptoms from the primary tumour dominated the initial clinical picture. Forty-one per cent had anaemia. The time from suspicion of colon cancer to established diagnosis of disseminated disease varied from 0 to 231days (emergency cases included, median 12days). The majority (77%) were diagnosed in hospital. In 53% the primary tumour and the metastases were not diagnosed on the same occasion which may increase the risk for misinformation or delays in the care process. The possibility of simultaneous diagnosis was doubled when the patient was investigated as an inpatient. Patients were seen by one to 12 physicians (median three) in the investigation phase, and one to 47 (median 11) from diagnosis until the last record in the hospital notes. The 1-year survival was 46%. ConclusionPatients with metastatic colon cancer at presentation are heterogeneous and warrant an adapted multidisciplinary approach to achieve the goal of individualized treatment for each patient in accordance with the Swedish national cancer strategy.

Place, publisher, year, edition, pages
Wiley: 12 months , 2015. Vol. 17, no 5, 403-408 p.
Keyword [en]
Colon cancer; diagnostic approach; metastases; heterogeneity; decision making; integrated care
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-118033DOI: 10.1111/codi.12864ISI: 000353565100014PubMedID: 25511984OAI: oai:DiVA.org:liu-118033DiVA: diva2:813086
Available from: 2015-05-21 Created: 2015-05-20 Last updated: 2016-03-29

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Starkhammar, HansSjödahl, Rune
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Regional Cancer Center South East SwedenDivision of Clinical SciencesFaculty of Medicine and Health SciencesFaculty of Health SciencesDepartment of Surgery in Linköping
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Colorectal Disease
Cancer and Oncology

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