Reply on "Data on the Characteristics and the Survival of Korean Patients With Colorectal Cancer From the Korea Central Cancer Registry"
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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].