The Risk Factors Affecting Survival in Colorectal Cancer in Taiwan

  • Chao-Hsien LEE Dept. of Health Business Administration, Meiho University, Pingtung, Taiwan
  • Shu-Chen CHENG Dept. of Cancer Registry Division, Cathay General Hospital, Taipei, Taiwan
  • Hong-Yi TUNG Dept. of Health Business Administration, Meiho University, Pingtung, Taiwan AND Dept. of General Surgery, Yuan’s General Hospital, Kaohsiung, Kaohsiung, Taiwan
  • Shih-Chang CHANG Dept. of Colorectal Surgery, Division of Surgery, Cathay General Hospital, Taipei, Taiwan
  • Ching-Yun CHING Dept. of Nursing, Yuan’s General Hospital, Kaohsiung, Taiwan
  • Shu-Fen WU Mail Dept. of Health Business Administration, Meiho University, Pingtung, Taiwan AND Dept. of Nursing, Yuan’s General Hospital, Kaohsiung, Taiwan AND Dept. of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
Risk factors, Survival, Colorectal cancer


Background: Colorectal cancer is one of the most common malignancies in developed countries. The incidence of colorectal cancer (CRC) in Taiwan is rising. We aimed to determine the five-yr survival rate of patients diagnosed with CRC and determine factors affecting survival.

Methods: All patients were identified from the Taiwan Cancer Data Base of the Medical Center Hospital in North Taiwan from 2007 to 2013. Data were collected using medical records and the cancer database. In all, 869 patients with CRC were included. Survival analysis was performed using Kaplan-Meier curves, and differences between the curves were analyzed using the log-rank test. Cox proportional hazards regression models were used to analyze survival by each variable.

Results: The five-yr survival rate and the mean survival time after cancer diagnosis were 68.7% and 71.27±1.27 months. Perineural nerve invasion, distant metastasis, age, pathological differentiation grade, obstruction and regional lymph node metastasis were found to be independent predictors of the survival and prognosis of patients with CRC.

Conclusion: Perineural nerve invasion was an important factor related to the survival of CRC patients. Thus, the earlier detection of CRC might help improve survival.



International Agency for Research on Can-cer (2013). GLOBOCAN 2012: Estimat-ed cancer incidence, mortality, and preva-lence worldwide in 2012. World Health Organization.

Siegel RL, Miller KD, Jemal A (2016). Can-cer statistics 2016. CA Cancer J Clin, 66(1):7-30.

Stewart BW, Wild CP (2014). World cancer report 2014. International Agency for Re-search on Cancer, World Health Organi-zation.

Torre LA, Bray F, Siegel RL et al (2015). Gobal cancer statistics, 2012. CA Cancer J Clin, 65: 87-108.

Bishehsari F, Mahdavinia M, Vacca M et al (2014) Epidemiological transition of colo-rectal cancer in developing countries: En-vironmental factors, molecular pathways, and opportunities for prevention. World J Gastroenterol, 20(20): 6055-6072.

Pourhoseingholi MA (2012). Increased bur-den of colorectal cancer in Asia. World J Gastrointest Oncol, 4(4): 68-70.

Veettil SK, Lim KG, Chaiyakunapruk N et al (2017). Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country. Asian J Surg, 40(6):481-489.

Health Promotion Administration, Ministry of Health and Welfare (2016). Cancer reg-istry annual report, 2013. Statis-ticsShow.aspx?No=201604210001

Cancer. Net. (2015). Colorectal cancer – sta-tistics.

Mathur A, Ware C, Davis L et al (2014). FGFR2 is amplified in the NCI-H716 colorectal cancer cell line and is required for growth and survival. PLoS One, 9(6): e98515.

Taiwan Cancer Registry. (2015). Cancer sur-vival rates in Taiwan.

Fang SC, Chao TB, Tung HY et al (2014). Analysis of prognostic factors to predict postoperative colorectal cancer patients survival. Med J South Taiwan, 10(2): 75-86.

Davari M, Maracy MR, Emami MH et al (2012). The Direct Medical Costs of Col-orectal Cancer in Iran; Analyzing the Pa-tient's Level Data from a Cancer Specific Hospital in Isfahan. Int J Prev Med, 3(12):887-892.

Corral J, Borràs JM, Chiarello P et al (2015). Estimacion del coste hospitalario del can-cer colorrectal en Catalu˜na (Spain). Gac Sanit, 29(6):437-444.

Chen PC, Lee JC, Wang JD (2015). Estima-tion of Life-Year Loss and Lifetime Costs for Different Stages of Colon Ad-enocarcinoma in Taiwan. PloS One, 10(7): e0133755.

Beckmann KR, Bennett A, Young GP et al (2016). Sociodemographic disparities in survival from colorectal cancer in South Australia: A population-wide data linkage study. BMC Health Serv Res, 16:24.

International Agency for Research on Can-cer. (2015). IARC monographs evaluate consumption of red meat and processed meat. World Health Organization.

Perron L, Daigle JM, Vandal N et al (2015). Characteristics affecting survival after lo-cally advanced colorectal cancer in Que-bec. Curr Oncol, 22(6): e485-e492.

Wang R, Wang MJ, Ping J (2015). Clinico-pathological features and survival out-comes of colorectal cancer in Young ver-sus elderly: A population-based cohort study of SEER 9 registries data (1988-2011). Medicine (Baltimore), 94(35): e1402.

Kornprat P, Pollheimer MJ, Lindtner RA et al (2011). Value of tumor size as a prog-nostic variable in colorectal cancer: A crit-ical reappraisal. Am J Clin Oncol, 34(1): 43-9.

Plummer JM, Leake PA, Ferron-Boothe D et al (2016). Colorectal cancer survival in Jamaica. Ann Med Surg (Lond), 6: 26-9.

Kao LC, Yang PF, Ma CJ et al (2013). The impact of metastatic ratio to retrieved re-gional lymph nodes on overall survival in patients with stage III. Journal Society of Co-lon and Rectal Surgeons, R.O.C, 24(2): 37-43.

Tsai TC, Lin WL, Chang SC et al (2014). The survival of stage II colorectal cancer patients is significantly affected by the numbers of lymph node retrieval. Medical Journal of South Taiwan, 10(2): 67-74.

Chou CL, Weng SF, Cheng LC et al (2013). National data on colorectal cancer trends: A population-based study in Taiwan. Journal of Society of Colon and Rectal Surgeons, R.O.C, 24(1): 1-8.

Hsu YJ, Tsai WS, Hsieh PS et al (2016). Worse survival in rectal cancer patients with preoperative radiotherapy compared to without radiotherapy in same postop-erative pathologic pN1 classification. Jour-nal of Society of Colon and Rectal Surgeons, R.O.C, 27(1): 7-14.

Zare-Bandamiri M, Khanjani N, Jahani Y et al (2016). Factors affecting survival in pa-tients with colorectal cancer in Shiraz, Iran. Asian Pac J Cancer Prev, 17(1): 159-63.

Agüero F, Murta-Nascimento C, Gallén M et al (2012). Colorectal cancer survival: Results from a hospital-based cancer reg-istry. Rev Esp Enferm Dig, 104(11): 572-7.

Yuan Y, Li MD, Hu HG et al (2013). Prog-nostic and survival analysis of 837 Chi-nese colorectal cancer patients. World J Gastroenterol, 19(17): 2650-9.

Kinoshita O, Kishimoto M, Murayama Y et al (2015). Poorly differentiated clusters with larger extents have a greater impact on survival: A semi-quantitative patholog-ical evaluation for 239 patients with non-mucinous pT2-3 colorectal carcinoma. World J Surg Oncol, 13: 140.

Hiranyakas A, da Silva G, Wexner SD et al (2013). Factors influencing circumferential resection margin in rectal cancer. Colorectal Dis, 15(3): 298-303.

Huh JW, Kim YJ, Kim HR (2010). Ratio of metastatic to resected lymph nodes as a prognostic factor in node-positive colo-rectal cancer. Ann Surg Oncol, 17(10): 2640-6.

Liebig C, Ayala G, Wilks J et al (2009). Peri-neural invasion is an independent predic-tor of outcome in colorectal cancer. J Clin Oncol, 27(31): 5131-7.

Cennamo V, Luigiano C, Coccolini F et al (2013). Meta-analysis of randomized trials comparing endoscopic stenting and sur-gical decompression for colorectal cancer obstruction. Int J Colorectal Dis, 28(6): 855-63.

Fu CY, Jao SW, Wu CC et al (2011). Com-parisons of characteristics and outcome of colorectal cancer in different age cate-gories: A retrospective analysis of a single institution in Taiwan. Journal of Society of Colon and Rectal Surgeons, R.O.C, 22(3): 57-64.

How to Cite
LEE C-H, CHENG S-C, TUNG H-Y, CHANG S-C, CHING C-Y, WU S-F. The Risk Factors Affecting Survival in Colorectal Cancer in Taiwan. Iran J Public Health. 47(4):519-530.
Original Article(s)