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Ann Coloproctol > Volume 30(3); 2014 > Article
Park and Lee: Reply on "Data on the Characteristics and the Survival of Korean Patients With Colorectal Cancer From the Korea Central Cancer Registry"
To the editor
Thank you for great interest to our article. Your comment has persuaded me to make a further analysis. I agree with your mention about difference of tumor distribution between Korea and Europe/America. The Korean patients showed a lower proportion of right sided colon cancer than European and American patients, which may represent geographical differences [1].
I would like to comment to stage distribution and survival. Recent report in America about stage distribution demonstrated that only 39% of colorectal cancer patients had localized-stage disease and about 34%-41% had regional disease, which was somewhat different to your table. They also reported that the 5-year relative survival in localized disease was 90%, and survival diagnosed at the regional and distant stage were 70% and 12%, respectively [2].
Nevertheless, Korean patients showed favorable survival. The intensive treatment and surveillance system under the national medical insurance may influence on this finding. For example, most Korean patients (more than 80%) in regional disease received adjuvant chemotherapy after surgery. Introduction of adjuvant chemotherapy was associated with improved survival in stage III colon cancer [3].
In addition, we included colorectal cancer patients recently developed; therefore, it may influence on favorable survival. Survival of colorectal cancer has improved in Europe and America [4, 5].

References

1. Park HC, Shin A, Kim BW, Jung KW, Won YJ, Oh JH, et al. Data on the characteristics and the survival of korean patients with colorectal cancer from the Korea central cancer registry. Ann Coloproctol 2013;29:144–149. PMID: 24032114.
crossref pmid pmc
2. American Cancer Society. Cancer facts & figures 2011-2013. Atlanta: American Cancer Society; 2011.
pmid
3. Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Goodman PJ, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 1990;322:352–358. PMID: 2300087.
crossref pmid
4. Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, et al. Recent cancer survival in Europe: a 2000-02 period analysis of EUROCARE-4 data. Lancet Oncol 2007;8:784–796. PMID: 17714993.
crossref pmid
5. Altekruse SF, Kosary CL, Krapcho W, Neyman N, Aminou R, Waldron W, et al. SEER cancer statistics review, 1975-2007. Bethesda: National Cancer Institute; 2010.



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