Overall Survival Following Radical Surgery and Postoperative Chemotherapy in Colorectal Cancer Patients Aged ≥70 Years: A Population-Based Retrospective Cohort Study

Overall Survival Following Radical Surgery and Postoperative Chemotherapy in Colorectal Cancer Patients Aged ≥70 Years: A Population-Based Retrospective Cohort Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Overall Survival Following Radical Surgery and Postoperative Chemotherapy in Colorectal Cancer Patients Aged ≥70 Years: A Population-Based Retrospective Cohort Study Ji-Yeon Mun, Kyungdo Han, Nina Yoo, Bong-Hyeon Kye, In-Kyu Lee This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6884777/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 Sep, 2025 Read the published version in BMC Cancer → Version 1 posted 10 You are reading this latest preprint version Abstract Background Colorectal cancer (CRC) predominantly affects the elderly, with a growing demand for evidence-based treatment strategies in this population. The influence of comorbidities and frailty on survival outcomes following postoperative chemotherapy in elderly CRC patients remains unclear. Method From the Korean National Health Insurance database, we analyzed 200,000 randomly sampled colorectal cancer patients (C18-20) diagnosed between 2009–2016. Patients under 20, those with inflammatory bowel disease, preoperative chemotherapy (except neoadjuvant chemoradiotherapy for rectal cancer), missing data, or death within 6 months post-surgery were excluded. Cox proportional hazards models estimated hazard ratios (HRs) for overall survival, adjusted for demographic factors. Subgroup and interaction analyses assessed effect modification by age, sex, and income. Incidence rates were reported per 1,000 person-years. Result Among 2,142 patients, 44.2% received postoperative chemotherapy. Chemotherapy recipients were younger and had lower overall mortality in the unadjusted analysis. However, after adjustment, postoperative chemotherapy was associated with an increased risk of mortality (adjusted hazard ratio [HR] 1.44, 95% CI: 1.10–1.87) in patients aged ≥ 70 years. The impact of chemotherapy on survival was more pronounced in younger patients. Comorbidity and frailty emerged as significant prognostic factors, potentially outweighing the benefits of adjuvant therapy in the elderly. Conclusion In elderly CRC patients, comorbidity and frailty may play a dominant role in determining overall survival, potentially exceeding the impact of tumor-directed treatments such as postoperative chemotherapy. These findings highlight the need for comprehensive geriatric assessment and individualized treatment planning in this population. colorectal neoplasms frailty comorbidity drug therapy surgical procedures Figures Figure 1 Introduction Colorectal cancer (CRC) is the third most commonly occurring cancer and the second most frequent cause of cancer death worldwide. [ 1 ] Globally, 60.4% of all cases were aged between 50 and 74 years at diagnosis. [ 2 ] Despite CRC in young individuals under 50 years is rapidly growing, the median age of onset is estimated as 67 years, and 80% of CRC occurs at the age of 70 and older. [ 2 ] As the elderly population expands, the demand for standard colorectal cancer treatments to older patients is on the rise. Ultimately, the aim of therapy is tumor eradication and long-term remission. If not possible, at least the treatment focuses on maintaining stable disease status while preserving a patient’s functional capacity. This may include radical surgery, with chemoradiotherapy being incorporated before and after the surgery, depending on the disease status at the initial presentation. Expectedly, prognosis depends on the stage of disease with expected 5-year OS of 70% for patients with stage II disease and 45–65% for patients with stage III disease according to the American Joint Committee on Cancer.[ 3 , 4 ] Furthermore, with advancement of treatment options for systemic and locoregional disease control, the life expectancy of patients with metastatic CRC has increased up to 32 to 40 months.[ 4 ] Previously, several studies have shown that comorbidities significantly influence the prognosis of patient survival.[ 5 – 7 ] In particular, concurrent comorbidity and frailty emerge as robust prognostic factors for survival in patients with CRC, beyond the commonly acknowledged sociodemographic and tumor characteristics.[ 7 ] As the aging population continues to grow, planning effective treatment for elderly patients becomes increasingly complex, given their frequent presentation with multiple comorbid conditions and heightened frailty. Therefore, it is essential to assess the effectiveness of current treatment strategies, which primarily include radical surgery and chemotherapy and/or radiotherapy, in elderly patients. This study investigates whether elderly patients (≥ 70 years) with CRC derive meaningful survival benefit from postoperative chemotherapy after radical resection using the National Sample Cohort (NSC) database from the Korean National Health Insurance Service (KNHIS). Materials and Methods Study population and database This is a nationwide, population-based, observational, retrospective cohort study. We utilized a sample cohort database provided by the KNHIS, which is composed of 2% patient samples that are randomly extracted from qualified National Health Insurance (NHI) subscribers and medical aid beneficiaries.[ 8 ] With nearly 97% of the Korean population enrolled, this national insurance service provides comprehensive medical coverage for both inpatient and outpatient care. The KNHIS has developed a database containing diagnoses (classified according to the International Classification of Diseases, 10th revision or ICD-10), procedures, prescription records, demographic information, and medical costs. The KNHIS manages and releases public data that includes demographic information, medical facility usage records, and diagnostic codes based on the Korean Standard Classification of Diseases, 7th Revision (KCD-7). The KCD-7 classification system aligns with the ICD-10 standards. In this study, we analyzed patients diagnosed with CRC between 2009 and 2016. The exclusion criteria comprised individuals who had surgical treatment more than three months after their initial diagnosis, those with a prior diagnosis of ulcerative colitis or Crohn’s disease, and patients who received systemic chemotherapy before surgical intervention, with the exception of those who underwent concurrent chemoradiotherapy for rectal cancer. Additionally, patients who died within six months of diagnosis were also excluded. This study complied with the principles outlined in the Declaration of Helsinki and received approval from the Institutional Review Board of the Catholic University of Korea, St. Vincent's Hospital (IRB # KC23ZISI0642). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent from individual patients was waived by the Institutional Review Board due to the retrospective design of the study, as the data utilized were public and anonymized in accordance with confidentiality guidelines. Definition of Colorectal cancer, Treatments, and Confounders CRC was identified based on the ICD-10 codes: colon cancer (C18 and C19) and rectal cancer (C20). Surgical treatment was defined by the procedural codes for colectomy, rectal and sigmoid colon resection, Hartmann’s procedure, and/or total or subtotal colectomy. We defined preoperative chemotherapy as any codes related to the mixing and infusion of chemotherapeutic agents, any substances related to irinotecan, capecitabine, or oxaliplatin, and/or nursing care for outpatient chemotherapy injections. Concurrent chemoradiotherapy was defined by codes that combine chemotherapy with substances related to 5-fluorouracil and radiation. Statistical analysis Baseline characteristics according to the receipt of chemotherapy were compared using the Student’s t-test for continuous variables and the chi-squared test for categorical variables. All data are presented as mean ± standard deviation (SD). Cox proportional hazards regression analysis was performed to evaluate the association between chemotherapy and mortality among patients with colorectal cancer. Incidence rates were calculated per 1,000 person-years of follow-up, stratified by treatment status and age groups (< 70 and ≥ 70 years). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to compare mortality risks between treated and untreated groups. To account for potential age-related differences in treatment effects, we conducted stratified analyses, adjusted for sex, age, and low income status. To adjust for potential confounding factors, we constructed and compared three models independently. Model 1 was analyzed without adjustment. Model 2 adjusted for age, sex, cancer stage, and comorbidities including hypertension, diabetes mellitus, and dyslipidemia. Model 3 included additional adjustments for body mass index (BMI), smoking status, alcohol consumption, and socioeconomic status, based on the variables included in Model 2. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the risk of mortality associated with chemotherapy. To further investigate the influence of other factors on the association between chemotherapy and mortality, subgroup analyses were conducted. Subgroup analyses were performed according to age group (≥ 65 years), sex, cancer stage, and the presence of major comorbidities such as diabetes mellitus and hypertension. All statistical analyses were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA). A p-value of < 0.05 was considered statistically significant. Results Table 1 summarizes patient demographics and characteristics. Of 2,142 patients, 44.2% received postoperative chemotherapy. Patients who received chemotherapy were significantly younger (mean age 60.7 vs. 67.0 years, p < 0.0001). Among those aged ≥70, a higher proportion of males received chemotherapy (63.6% vs. 53.6%, p = 0.0099). Colon cancer was more common in chemotherapy recipients under 70 (77.9% vs. 73.0%, p = 0.0398). Colectomy was more frequent in non-chemotherapy patients aged ≥70 (46.5% vs. 36.9%, p = 0.0119). Mortality was lower in the chemotherapy group overall (22.2% vs. 29.0%, p = 0.0003), especially in patients under 70 (7.9% vs. 25.8%, p < 0.0001), but not in those aged ≥70. No significant differences were observed in low-income status or cancer site distribution in the overall cohort. As shown in Fig 1. Kaplan-Meier survival analysis demonstrated that patients who received postoperative chemotherapy had lower survival probabilities compared to those who did not receive chemotherapy. This pattern was observed in the overall cohort (Figure 1a), as well as in both age subgroups: patients younger than 70 years (Figure 1b) and those aged 70 years or older (Figure 1c). In all groups, the survival curve for the chemotherapy group consistently lay below that of the non-chemotherapy group, indicating poorer survival among patients who underwent postoperative chemotherapy. Table 2 presents the mortality risks associated with postoperative chemotherapy compared to no chemotherapy, with analyses stratified by age groups (<70 and ≥70 years) and adjusted for relevant covariates. Overall, patients who received postoperative chemotherapy exhibited a higher incidence rate (IR) of mortality (74.1 per 1,000 person-years) compared to those who did not receive chemotherapy (66.6 per 1,000 person-years). The adjusted hazard ratio (HR) for mortality in the chemotherapy group was 1.877 (95% CI: 1.572–2.241), indicating a significantly increased risk compared to the non-chemotherapy group. In patients younger than 70 years, the adjusted HR was even higher at 3.831 (95% CI: 2.799–5.242), while in those aged 70 years or older, the adjusted HR was 1.437 (95% CI: 1.102–1.874). Table 3 shows that postoperative chemotherapy is associated with an increased risk of mortality after colorectal cancer treatment across most subgroups, with higher adjusted hazard ratios (HRs) seen especially in patients under 70 years old and in females. The increased risk is consistent regardless of sex or income status, though the magnitude varies. In patients aged 70 or older, the association between chemotherapy and mortality is weaker and not always statistically significant. Overall, the mortality risk linked to postoperative chemotherapy is most pronounced in younger and female patients. Discussion This nationwide, population-based cohort study investigating survival outcomes after postoperative chemotherapy following radical surgery for colorectal cancer demonstrates that survival was significantly worse in patients who received postoperative chemotherapy compared to those who did not, with an adjusted hazard ratio (HR) for mortality of 1.88 overall. The risk was notably higher in patients under 70 years old (adjusted HR 3.83), while it remained elevated but less pronounced in those aged 70 or older (adjusted HR 1.44). Among patients aged 70 or older, the association between chemotherapy and mortality was weaker and not always statistically significant. Overall, the negative impact on survival associated with postoperative chemotherapy was most pronounced in younger patients. Our findings suggest that in elderly patients with colorectal cancer, the impact of postoperative chemotherapy on overall survival is attenuated compared to younger patients. This may indicate that, in the elderly population, age-related factors—such as comorbidity burden, frailty, and limited life expectancy—may play a more decisive role in determining overall survival than tumor-directed interventions alone. In contrast, among younger patients, tumor-related factors and treatment effects may exert a greater influence on survival outcomes. This phenomenon is consistent with a previous finding indicating that the magnitude of benefit from adjuvant chemotherapy is lower in elderly patients compared to younger patients; specifically, the benefit is significantly greater in those under 70 years of age than in those aged 70 or older.[ 9 ] The prognostic importance of comorbid conditions is most evident when the cancer itself is less aggressive and associated with better expected survival.[ 5 , 10 ] In contrast, when the tumor is advanced or rapidly progressive, the influence of comorbidity on overall prognosis would be less significant. A large cohort study demonstrated that the effect of comorbidity on overall survival was most pronounced among patients with cancers associated with a relatively favorable prognosis—such as localized colon cancer—while it was less significant in those with advanced or aggressive cancers.[ 6 ] This evidence helps explain our observation that, in elderly patients with colorectal cancer, non-tumor factors, such as comorbidity and frailty, may play a dominant role in determining overall survival—potentially exceeding the impact of tumor-directed treatments like chemotherapy. As the burden of comorbidity increases with age, its influence on survival becomes more pronounced, especially in early-stage disease, and may mask or outweigh any benefits from adjuvant therapies. Furthermore, a recent systematic review and meta-analysis evaluating the prognostic significance of frailty in patients with colorectal cancer demonstrated frailty was a strong predictor of both 30-day and 5-year mortality, with relative risks (RR) for mortality ranging from 2.26 to over 6.0 compared to non-frail patients.[ 11 ] This evidence reinforces our observation that age-related factors such as frailty and comorbidity may play a decisive role in survival among elderly patients with colorectal cancer, potentially outweighing the impact of tumor-directed treatments like chemotherapy. The authors further insisted that the importance of incorporating frailty assessment into clinical decision-making for elderly CRC patients, as frail individuals are at substantially higher risk for adverse outcomes regardless of the oncologic intervention. These may explain no clear benefit of adding oxaliplatin to 5-fluorouracil in adjuvant setting. [ 12 , 13 ] This study has several limitations. Firstly, while our study examines associations between postoperative chemotherapy and overall survival across different age groups, we did not directly quantify or compare the relative impact of tumor-specific factors, such as stage or grade, versus patient-specific factors, such as comorbidity burden or age, on survival outcomes. As a result, our conclusions regarding the predominance of non-tumor factors in elderly patients are inferential, rather than directly demonstrated by our data. Secondly, our analysis did not include stratified survival curves or hazard models adjusted for tumor stage or comorbidity indices. Stage-specific survival analysis would allow for a clearer understanding of how the effect of chemotherapy varies within each stage, while comorbidity-adjusted analyses would help isolate the impact of treatment from underlying health status. The lack of these adjustments limits our ability to distinguish whether observed survival differences are primarily driven by cancer progression or by competing risks from other illnesses, particularly in the elderly cohort. Finally, there is a possibility of selection bias in our study population, especially among elderly patients. In clinical practice, patients with significant frailty, multiple comorbidities, or poor performance status are less likely to be offered or to tolerate postoperative chemotherapy. Conversely, those elderly patients who do receive chemotherapy may represent a selectively healthier subgroup, or, alternatively, may be those with more aggressive disease. This confounding by indication could distort the observed association between chemotherapy and survival, making it difficult to determine whether poorer outcomes are due to the treatment itself, the underlying health of the patient, or the biology of more advanced tumors. Without detailed data on performance status, frailty measures, or reasons for treatment selection, this potential bias cannot be fully addressed. Conclusion This study suggests that, in elderly patients with colorectal cancer, non-tumor factors of comorbidity and frailty may play a dominant role in determining overall survival—potentially exceeding the impact of tumor-directed treatments like surgery and chemotherapy. As the burden of comorbidity frailty increases with age, its influence on survival becomes more pronounced, especially in early-stage disease, and may mask or outweigh any benefits from adjuvant therapies. However, these findings should be interpreted with caution due to several important limitations. Future research incorporating more detailed clinical data and robust analytical methods is needed to clarify the interplay between tumor characteristics, patient comorbidities, and treatment effects in elderly cancer patients. Declarations Funding The authors acknowledge the financial support of the St. Vincent’s Hospital, The Catholic University of Korea, Research Institute of Medical Science Foundation (SVHR-BD-2024-01). Competing interests The authors declare that they have no competing interests. Author Contribution KH prepared and analyzed the data and created the tables and figure. NY, JM, BK, IL interpreted the patient data. NY wrote the main manuscript text. All authors read and approved the final manuscript. Data Availability The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. References Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F: Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries . CA Cancer J Clin 2021, 71 (3):209-249. 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Clin Colorectal Cancer 2018, 17 (3):e489-e498. Cai M, Gao Z, Liao J, Jiang Y, He Y: Frailty affects prognosis in patients with colorectal cancer: A systematic review and meta-analysis . Front Oncol 2022, 12 :1017183. McCleary NJ, Meyerhardt JA, Green E, Yothers G, de Gramont A, Van Cutsem E, O'Connell M, Twelves CJ, Saltz LB, Haller DG et al : Impact of age on the efficacy of newer adjuvant therapies in patients with stage II/III colon cancer: findings from the ACCENT database . J Clin Oncol 2013, 31 (20):2600-2606. Sanoff HK, Carpenter WR, Stürmer T, Goldberg RM, Martin CF, Fine JP, McCleary NJ, Meyerhardt JA, Niland J, Kahn KL et al : Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years . J Clin Oncol 2012, 30 (21):2624-2634. Tables Table 1. Patient demographics and characteristics TOTAL Postoperative chemotherapy (in Total) Postoperative chemotherapy in Age<70 (N=1343) Postoperative chemotherapy in Age≥70 (N=799) No Yes p No Yes p No Yes p N (%) 2142 (100) 1197 (55.8) 945 (44.2) 634 (47.2) 709 (52.8) 563 (70.4) 236 (29.9) Sex Male 1273(59.43) 701(58.56) 572(60.53) 0.3575 399(62.93) 422(59.52) 0.2002 302(53.64) 150(63.56) 0.0099 Female 869(40.57) 496(41.44) 373(39.47) 235(37.07) 287(40.48) 261(46.36) 86(36.44) Age Mean±SD 64.24±12.02 67±12.01 60.74±11.09 <.0001 57.91±8.53 56.4±9.2 0.002 77.24±5.17 73.77±3.47 <.0001 20-39 64(2.99) 24(2.01) 40(4.23) <.0001 24(3.79) 40(5.64) 0.0093 <.0001 40-59 659(30.77) 291(24.31) 368(38.94) 291(45.9) 368(51.9) 60-69 620(28.94) 319(26.65) 301(31.85) 319(50.32) 301(42.45) 70-79 602(28.1) 381(31.83) 221(23.39) 381(67.67) 221(93.64) ≥80 197(9.2) 182(15.2) 15(1.59) 182(32.33) 15(6.36) Social status Low income status 354(16.53) 192(16.04) 162(17.14) 0.4951 111(17.51) 124(17.49) 0.9929 81(14.39) 38(16.1) 0.5346 Colorectal ICD-10 code Colon C18-C19 1633(76.24) 899(75.1) 734(77.67) 0.1657 463(73.03) 552(77.86) 0.0398 436(77.44) 182(77.12) 0.9206 Rectum C20 509(23.76) 298(24.9) 211(22.33) 171(26.97) 157(22.14) 127(22.56) 54(22.88) Type of surgery Colectomy 808(37.72) 478(39.93) 330(34.92) 0.0586 216(34.07) 243(34.27) 0.991 262(46.54) 87(36.86) 0.0119 Anterior resection or Low anterior resection 1330(62.09) 717(59.9) 613(64.87) 416(65.62) 464(65.44) 301(53.46) 149(63.14) Total or subtotal colectomy 4(0.19) 2(0.17) 2(0.21) 2(0.32) 2(0.28) Time from surgery to first chemo (days) 96.05±265.12 820.73±602.41 37±21.83 <.0001 839.49±613.35 35.49±19.86 <.0001 803.38±599.41 41.54±26.43 <.0001 Death 540(25.21) 266(22.22) 274(28.99) 0.0003 50(7.89) 183(25.81) <.0001 216(38.37) 91(38.56) 0.9591 Follow-up duration Mean±SD 5.37±2.69 5.53±2.67 5.16±2.71 0.0013 6.26±2.39 5.35±2.67 <.0001 4.72±2.75 4.57±2.73 0.4921 Median (Q1-Q3) 5.31 (3.35-7.46) 5.6 (3.52-7.61) 4.96 (3.18-7.23) 0.0035 6.32 (4.38-8.18) 5.22 (3.45-7.42) <.0001 4.56 (2.67-6.88) 4.23 (2.57-6.71) 0.452 TOTAL Postoperative chemotherapy (in Total) Postoperative chemotherapy in Age<70 (N=1343) Postoperative chemotherapy in Age≥70 (N=799) No Yes p No Yes p No Yes p N (%) 2142 (100) 1197 (55.8) 945 (44.2) 634 (47.2) 709 (52.8) 563 (70.4) 236 (29.9) Sex Male 1273(59.43) 701(58.56) 572(60.53) 0.3575 399(62.93) 422(59.52) 0.2002 302(53.64) 150(63.56) 0.0099 Female 869(40.57) 496(41.44) 373(39.47) 235(37.07) 287(40.48) 261(46.36) 86(36.44) Age Mean±SD 64.24±12.02 67±12.01 60.74±11.09 <.0001 57.91±8.53 56.4±9.2 0.002 77.24±5.17 73.77±3.47 <.0001 20-39 64(2.99) 24(2.01) 40(4.23) <.0001 24(3.79) 40(5.64) 0.0093 <.0001 40-59 659(30.77) 291(24.31) 368(38.94) 291(45.9) 368(51.9) 60-69 620(28.94) 319(26.65) 301(31.85) 319(50.32) 301(42.45) 70-79 602(28.1) 381(31.83) 221(23.39) 381(67.67) 221(93.64) ≥80 197(9.2) 182(15.2) 15(1.59) 182(32.33) 15(6.36) Social status Low income status 354(16.53) 192(16.04) 162(17.14) 0.4951 111(17.51) 124(17.49) 0.9929 81(14.39) 38(16.1) 0.5346 Colorectal ICD-10 code Colon C18-C19 1633(76.24) 899(75.1) 734(77.67) 0.1657 463(73.03) 552(77.86) 0.0398 436(77.44) 182(77.12) 0.9206 Rectum C20 509(23.76) 298(24.9) 211(22.33) 171(26.97) 157(22.14) 127(22.56) 54(22.88) Type of surgery Colectomy 808(37.72) 478(39.93) 330(34.92) 0.0586 216(34.07) 243(34.27) 0.991 262(46.54) 87(36.86) 0.0119 Anterior resection or Low anterior resection 1330(62.09) 717(59.9) 613(64.87) 416(65.62) 464(65.44) 301(53.46) 149(63.14) Total or subtotal colectomy 4(0.19) 2(0.17) 2(0.21) 2(0.32) 2(0.28) Time from surgery to first chemo (days) 96.05±265.12 820.73±602.41 37±21.83 <.0001 839.49±613.35 35.49±19.86 <.0001 803.38±599.41 41.54±26.43 <.0001 Death 540(25.21) 266(22.22) 274(28.99) 0.0003 50(7.89) 183(25.81) <.0001 216(38.37) 91(38.56) 0.9591 Follow-up duration Mean±SD 5.37±2.69 5.53±2.67 5.16±2.71 0.0013 6.26±2.39 5.35±2.67 <.0001 4.72±2.75 4.57±2.73 0.4921 Median (Q1-Q3) 5.31 (3.35-7.46) 5.6 (3.52-7.61) 4.96 (3.18-7.23) 0.0035 6.32 (4.38-8.18) 5.22 (3.45-7.42) <.0001 4.56 (2.67-6.88) 4.23 (2.57-6.71) 0.452 Table 2. The mortality risks between postoperative chemotherapy and no chemotherapy groups Postoperative chemotherapy N DEATH Duration, PY IR, 1000 PY HR (95% CI) Model 1 P Model 2 P in Total No 1197 266 6624.61 40.15 1 (Ref.) 0.0002 1 (Ref.) <.0001 Yes 945 274 4874.09 56.22 1.382 (1.167,1.636) 1.877 (1.572,2.241) in Age <70 No 634 50 3966.75 12.60 1 (Ref.) <.0001 1 (Ref.) <.0001 Yes 709 183 3794.43 48.23 3.762 (2.751,5.146) 3.831 (2.799,5.242) in Age≥70 No 563 216 2657.86 81.27 1 (Ref.) 0.8218 1 (Ref.) 0.0075 Yes 236 91 1079.66 84.29 1.029 (0.805,1.314) 1.437 (1.102,1.874) Model 1 Non-adjusted Model 2 Adjusted by sex, age, and income status PY, person-years; IR, Incidence rate; HR, Hazard ratio; CI, Confidence interval Table 3. Subgroup analysis on the mortality risks after colorectal cancer treatment Postoperative chemotherapy N DEATH (N) Duration, PY IR, 1000-PY HR (95% CI) Model 1 P for interaction Model 2 P for interaction in Total Sex Male No 701 167 3878.43 43.06 1(Ref.) 0.8864 1(Ref.) 0.1333 Yes 572 173 2891.66 59.83 1.367(1.105,1.69) 1.705(1.373,2.118) Female No 496 99 2746.18 36.05 1(Ref.) 1(Ref.) Yes 373 101 1982.42 50.95 1.402(1.062,1.85) 2.231(1.675,2.972) Age 20-69 No 634 50 3966.75 12.60 1(Ref.) <.0001 1(Ref.) <.0001 Yes 709 183 3794.43 48.23 3.75(2.742,5.127) 3.926(2.87,5.37) ≥70 No 563 216 2657.86 81.27 1(Ref.) 1(Ref.) Yes 236 91 1079.66 84.29 1.031(0.807,1.317) 1.117(0.87,1.434) Income status Others No 1005 223 5610.62 39.75 1(Ref.) 0.6032 1(Ref.) 0.4921 Yes 783 230 4045.94 56.85 1.409(1.172,1.694) 1.927(1.59,2.334) Low No 192 43 1013.99 42.41 1(Ref.) 1(Ref.) Yes 162 44 828.14 53.13 1.248(0.82,1.899) 1.64(1.074,2.505) in Age <70 Sex Male No 399 40 2483.66 16.11 1(Ref.) 0.0649 1(Ref.) 0.0562 Yes 422 114 2210.33 51.58 3.137(2.188,4.499) 3.135(2.186,4.496) Female No 235 10 1483.09 6.74 1(Ref.) 1(Ref.) Yes 287 69 1584.1 43.56 6.387(3.29,12.4) 6.553(3.368,12.748) Income status Others No 523 38 3315.49 11.46 1(Ref.) 0.0631 1(Ref.) 0.0728 Yes 585 157 3116.36 50.38 4.311(3.024,6.147) 4.368(3.062,6.232) Low No 111 12 651.26 18.43 1(Ref.) 1(Ref.) Yes 124 26 678.07 38.34 2.076(1.048,4.115) 2.156(1.087,4.277) in Age ≥70 Sex Male No 302 127 1394.77 91.05 1(Ref.) 0.5126 1(Ref.) 0.3184 Yes 150 59 681.34 86.59 0.948(0.696,1.292) 1.313(0.951,1.813) Female No 261 89 1263.09 70.46 1(Ref.) 1(Ref.) Yes 86 32 398.32 80.34 1.124(0.75,1.684) 1.702(1.119,2.589) Income status Others No 482 185 2295.13 80.61 1(Ref.) 0.307 1(Ref.) 0.2333 Yes 198 73 929.58 78.53 0.97(0.74,1.272) 1.348(1.01,1.799) Low No 81 31 362.73 85.46 1(Ref.) 1(Ref.) Yes 38 18 150.07 119.94 1.355(0.758,2.423) 1.992(1.1,3.609) Model 1 Non-adjusted Model 2 adjusted by sex, Age, Income status PY, person-years; IR, Incidence rate; HR, Hazard ratio; CI, Confidence interval Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 02 Sep, 2025 Read the published version in BMC Cancer → Version 1 posted Editorial decision: Revision requested 04 Aug, 2025 Reviews received at journal 30 Jul, 2025 Reviewers agreed at journal 30 Jul, 2025 Reviews received at journal 30 Jul, 2025 Reviewers agreed at journal 30 Jul, 2025 Reviewers invited by journal 29 Jul, 2025 Editor invited by journal 27 Jul, 2025 Editor assigned by journal 23 Jun, 2025 Submission checks completed at journal 23 Jun, 2025 First submitted to journal 13 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6884777","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":493396048,"identity":"dbf83d3c-de48-4bb0-bfa6-a7649fc0c038","order_by":0,"name":"Ji-Yeon Mun","email":"","orcid":"","institution":"St. Vincent's Hospital The Catholic University of Korea","correspondingAuthor":false,"prefix":"","firstName":"Ji-Yeon","middleName":"","lastName":"Mun","suffix":""},{"id":493396049,"identity":"27160c5d-cb89-4ebb-b681-518b01535505","order_by":1,"name":"Kyungdo Han","email":"","orcid":"","institution":"Soongsil University","correspondingAuthor":false,"prefix":"","firstName":"Kyungdo","middleName":"","lastName":"Han","suffix":""},{"id":493396051,"identity":"fd0d96c7-0c18-4b8a-8941-1dcf534a0e3a","order_by":2,"name":"Nina Yoo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA60lEQVRIiWNgGAWjYDACZgglB8RsDAwFEmAeYwMRWoyBLKAWA2K0QEFiA0QLA2Et5uy8Bz/zVNik97efP/bgg4GFPAP74QeMM/fg1mLZzJcszXMmLXfGmWR2wxkGEoYNPGkGjBue4dZicJjHQJq37XDuBoZkNmkeA4kEBoYcBsYHB/BqMf4N1JJuwP8YqoX/DUEtZiBbEgwkYLZIAG3ZQECL5ZwzaYYzbjw2kwT5pU3imcHBGfi0nD9jfONNhY08f3/iM4kPFXXy/PzJDx/24NECAkw8yDxg7DAQ0ACMuB+EVIyCUTAKRsHIBgCvA0aSyMGwhwAAAABJRU5ErkJggg==","orcid":"","institution":"St. Vincent's Hospital The Catholic University of Korea","correspondingAuthor":true,"prefix":"","firstName":"Nina","middleName":"","lastName":"Yoo","suffix":""},{"id":493396052,"identity":"52373eeb-9886-41a2-ba9a-8116fc448641","order_by":3,"name":"Bong-Hyeon Kye","email":"","orcid":"","institution":"St. Vincent's Hospital The Catholic University of Korea","correspondingAuthor":false,"prefix":"","firstName":"Bong-Hyeon","middleName":"","lastName":"Kye","suffix":""},{"id":493396053,"identity":"531e5cd3-dcb3-4ff7-97b3-63236843ada3","order_by":4,"name":"In-Kyu Lee","email":"","orcid":"","institution":"Seoul St. Mary's Hospital","correspondingAuthor":false,"prefix":"","firstName":"In-Kyu","middleName":"","lastName":"Lee","suffix":""}],"badges":[],"createdAt":"2025-06-13 05:23:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6884777/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6884777/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12885-025-14863-w","type":"published","date":"2025-09-02T15:58:04+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":88237106,"identity":"b64c1c99-0869-4724-b179-354f63945db8","added_by":"auto","created_at":"2025-08-04 10:36:43","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":107127,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan-Meier Curves\u003c/p\u003e\n\u003cp\u003eKaplan-Meier survival curves of the patients who received postoperative chemotherapy compared to those who did not, (1a) both in the overall cohort (1b) patients younger than 70 years (1c) aged 70 years or older\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6884777/v1/a24ae29b81ad6912bfd0f9d0.png"},{"id":90828117,"identity":"8dd5057a-d568-44e3-badc-b5ac18a75cc8","added_by":"auto","created_at":"2025-09-08 16:05:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1438285,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6884777/v1/ae61277c-b940-4289-832a-85c7789346b1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Overall Survival Following Radical Surgery and Postoperative Chemotherapy in Colorectal Cancer Patients Aged ≥70 Years: A Population-Based Retrospective Cohort Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eColorectal cancer (CRC) is the third most commonly occurring cancer and the second most frequent cause of cancer death worldwide. [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] Globally, 60.4% of all cases were aged between 50 and 74 years at diagnosis. [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] Despite CRC in young individuals under 50 years is rapidly growing, the median age of onset is estimated as 67 years, and 80% of CRC occurs at the age of 70 and older. [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] As the elderly population expands, the demand for standard colorectal cancer treatments to older patients is on the rise.\u003c/p\u003e\u003cp\u003eUltimately, the aim of therapy is tumor eradication and long-term remission. If not possible, at least the treatment focuses on maintaining stable disease status while preserving a patient\u0026rsquo;s functional capacity. This may include radical surgery, with chemoradiotherapy being incorporated before and after the surgery, depending on the disease status at the initial presentation. Expectedly, prognosis depends on the stage of disease with expected 5-year OS of 70% for patients with stage II disease and 45\u0026ndash;65% for patients with stage III disease according to the American Joint Committee on Cancer.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] Furthermore, with advancement of treatment options for systemic and locoregional disease control, the life expectancy of patients with metastatic CRC has increased up to 32 to 40 months.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e\u003cp\u003ePreviously, several studies have shown that comorbidities significantly influence the prognosis of patient survival.[\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] In particular, concurrent comorbidity and frailty emerge as robust prognostic factors for survival in patients with CRC, beyond the commonly acknowledged sociodemographic and tumor characteristics.[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] As the aging population continues to grow, planning effective treatment for elderly patients becomes increasingly complex, given their frequent presentation with multiple comorbid conditions and heightened frailty. Therefore, it is essential to assess the effectiveness of current treatment strategies, which primarily include radical surgery and chemotherapy and/or radiotherapy, in elderly patients. This study investigates whether elderly patients (\u0026ge;\u0026thinsp;70 years) with CRC derive meaningful survival benefit from postoperative chemotherapy after radical resection using the National Sample Cohort (NSC) database from the Korean National Health Insurance Service (KNHIS).\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eStudy population and database\u003c/p\u003e\u003cp\u003eThis is a nationwide, population-based, observational, retrospective cohort study. We utilized a sample cohort database provided by the KNHIS, which is composed of 2% patient samples that are randomly extracted from qualified National Health Insurance (NHI) subscribers and medical aid beneficiaries.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] With nearly 97% of the Korean population enrolled, this national insurance service provides comprehensive medical coverage for both inpatient and outpatient care. The KNHIS has developed a database containing diagnoses (classified according to the International Classification of Diseases, 10th revision or ICD-10), procedures, prescription records, demographic information, and medical costs. The KNHIS manages and releases public data that includes demographic information, medical facility usage records, and diagnostic codes based on the Korean Standard Classification of Diseases, 7th Revision (KCD-7). The KCD-7 classification system aligns with the ICD-10 standards.\u003c/p\u003e\u003cp\u003eIn this study, we analyzed patients diagnosed with CRC between 2009 and 2016. The exclusion criteria comprised individuals who had surgical treatment more than three months after their initial diagnosis, those with a prior diagnosis of ulcerative colitis or Crohn\u0026rsquo;s disease, and patients who received systemic chemotherapy before surgical intervention, with the exception of those who underwent concurrent chemoradiotherapy for rectal cancer. Additionally, patients who died within six months of diagnosis were also excluded.\u003c/p\u003e\u003cp\u003e This study complied with the principles outlined in the Declaration of Helsinki and received approval from the Institutional Review Board of the Catholic University of Korea, St. Vincent's Hospital (IRB # KC23ZISI0642). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent from individual patients was waived by the Institutional Review Board due to the retrospective design of the study, as the data utilized were public and anonymized in accordance with confidentiality guidelines.\u003c/p\u003e\u003cp\u003eDefinition of Colorectal cancer, Treatments, and Confounders\u003c/p\u003e\u003cp\u003eCRC was identified based on the ICD-10 codes: colon cancer (C18 and C19) and rectal cancer (C20). Surgical treatment was defined by the procedural codes for colectomy, rectal and sigmoid colon resection, Hartmann\u0026rsquo;s procedure, and/or total or subtotal colectomy. We defined preoperative chemotherapy as any codes related to the mixing and infusion of chemotherapeutic agents, any substances related to irinotecan, capecitabine, or oxaliplatin, and/or nursing care for outpatient chemotherapy injections. Concurrent chemoradiotherapy was defined by codes that combine chemotherapy with substances related to 5-fluorouracil and radiation.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eBaseline characteristics according to the receipt of chemotherapy were compared using the Student\u0026rsquo;s t-test for continuous variables and the chi-squared test for categorical variables. All data are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD). Cox proportional hazards regression analysis was performed to evaluate the association between chemotherapy and mortality among patients with colorectal cancer. Incidence rates were calculated per 1,000 person-years of follow-up, stratified by treatment status and age groups (\u0026lt;\u0026thinsp;70 and \u0026ge;\u0026thinsp;70 years). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to compare mortality risks between treated and untreated groups. To account for potential age-related differences in treatment effects, we conducted stratified analyses, adjusted for sex, age, and low income status.\u003c/p\u003e\u003cp\u003eTo adjust for potential confounding factors, we constructed and compared three models independently. Model 1 was analyzed without adjustment. Model 2 adjusted for age, sex, cancer stage, and comorbidities including hypertension, diabetes mellitus, and dyslipidemia. Model 3 included additional adjustments for body mass index (BMI), smoking status, alcohol consumption, and socioeconomic status, based on the variables included in Model 2. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the risk of mortality associated with chemotherapy.\u003c/p\u003e\u003cp\u003eTo further investigate the influence of other factors on the association between chemotherapy and mortality, subgroup analyses were conducted. Subgroup analyses were performed according to age group (\u0026ge;\u0026thinsp;65 years), sex, cancer stage, and the presence of major comorbidities such as diabetes mellitus and hypertension. All statistical analyses were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA). A p-value of \u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTable 1 summarizes patient demographics and characteristics. Of 2,142 patients, 44.2% received postoperative chemotherapy. Patients who received chemotherapy were significantly younger (mean age 60.7 vs. 67.0 years, p \u0026lt; 0.0001). Among those aged \u0026ge;70, a higher proportion of males received chemotherapy (63.6% vs. 53.6%, p = 0.0099). Colon cancer was more common in chemotherapy recipients under 70 (77.9% vs. 73.0%, p = 0.0398). Colectomy was more frequent in non-chemotherapy patients aged \u0026ge;70 (46.5% vs. 36.9%, p = 0.0119). Mortality was lower in the chemotherapy group overall (22.2% vs. 29.0%, p = 0.0003), especially in patients under 70 (7.9% vs. 25.8%, p \u0026lt; 0.0001), but not in those aged \u0026ge;70. No significant differences were observed in low-income status or cancer site distribution in the overall cohort.\u003c/p\u003e\n\u003cp\u003eAs shown in Fig 1. Kaplan-Meier survival analysis demonstrated that patients who received postoperative chemotherapy had lower survival probabilities compared to those who did not receive chemotherapy. This pattern was observed in the overall cohort (Figure 1a), as well as in both age subgroups: patients younger than 70 years (Figure 1b) and those aged 70 years or older (Figure 1c). In all groups, the survival curve for the chemotherapy group consistently lay below that of the non-chemotherapy group, indicating poorer survival among patients who underwent postoperative chemotherapy.\u003c/p\u003e\n\u003cp\u003eTable 2 presents the mortality risks associated with postoperative chemotherapy compared to no chemotherapy, with analyses stratified by age groups (\u0026lt;70 and \u0026ge;70 years) and adjusted for relevant covariates. Overall, patients who received postoperative chemotherapy exhibited a higher incidence rate (IR) of mortality (74.1 per 1,000 person-years) compared to those who did not receive chemotherapy (66.6 per 1,000 person-years). The adjusted hazard ratio (HR) for mortality in the chemotherapy group was 1.877 (95% CI: 1.572\u0026ndash;2.241), indicating a significantly increased risk compared to the non-chemotherapy group. In patients younger than 70 years, the adjusted HR was even higher at 3.831 (95% CI: 2.799\u0026ndash;5.242), while in those aged 70 years or older, the adjusted HR was 1.437 (95% CI: 1.102\u0026ndash;1.874).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3 shows that postoperative chemotherapy is associated with an increased risk of mortality after colorectal cancer treatment across most subgroups, with higher adjusted hazard ratios (HRs) seen especially in patients under 70 years old and in females. The increased risk is consistent regardless of sex or income status, though the magnitude varies. In patients aged 70 or older, the association between chemotherapy and mortality is weaker and not always statistically significant. Overall, the mortality risk linked to postoperative chemotherapy is most pronounced in younger and female patients.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis nationwide, population-based cohort study investigating survival outcomes after postoperative chemotherapy following radical surgery for colorectal cancer demonstrates that survival was significantly worse in patients who received postoperative chemotherapy compared to those who did not, with an adjusted hazard ratio (HR) for mortality of 1.88 overall. The risk was notably higher in patients under 70 years old (adjusted HR 3.83), while it remained elevated but less pronounced in those aged 70 or older (adjusted HR 1.44). Among patients aged 70 or older, the association between chemotherapy and mortality was weaker and not always statistically significant. Overall, the negative impact on survival associated with postoperative chemotherapy was most pronounced in younger patients. Our findings suggest that in elderly patients with colorectal cancer, the impact of postoperative chemotherapy on overall survival is attenuated compared to younger patients. This may indicate that, in the elderly population, age-related factors\u0026mdash;such as comorbidity burden, frailty, and limited life expectancy\u0026mdash;may play a more decisive role in determining overall survival than tumor-directed interventions alone. In contrast, among younger patients, tumor-related factors and treatment effects may exert a greater influence on survival outcomes. This phenomenon is consistent with a previous finding indicating that the magnitude of benefit from adjuvant chemotherapy is lower in elderly patients compared to younger patients; specifically, the benefit is significantly greater in those under 70 years of age than in those aged 70 or older.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eThe prognostic importance of comorbid conditions is most evident when the cancer itself is less aggressive and associated with better expected survival.[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] In contrast, when the tumor is advanced or rapidly progressive, the influence of comorbidity on overall prognosis would be less significant. A large cohort study demonstrated that the effect of comorbidity on overall survival was most pronounced among patients with cancers associated with a relatively favorable prognosis\u0026mdash;such as localized colon cancer\u0026mdash;while it was less significant in those with advanced or aggressive cancers.[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] This evidence helps explain our observation that, in elderly patients with colorectal cancer, non-tumor factors, such as comorbidity and frailty, may play a dominant role in determining overall survival\u0026mdash;potentially exceeding the impact of tumor-directed treatments like chemotherapy. As the burden of comorbidity increases with age, its influence on survival becomes more pronounced, especially in early-stage disease, and may mask or outweigh any benefits from adjuvant therapies.\u003c/p\u003e\u003cp\u003eFurthermore, a recent systematic review and meta-analysis evaluating the prognostic significance of frailty in patients with colorectal cancer demonstrated frailty was a strong predictor of both 30-day and 5-year mortality, with relative risks (RR) for mortality ranging from 2.26 to over 6.0 compared to non-frail patients.[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] This evidence reinforces our observation that age-related factors such as frailty and comorbidity may play a decisive role in survival among elderly patients with colorectal cancer, potentially outweighing the impact of tumor-directed treatments like chemotherapy. The authors further insisted that the importance of incorporating frailty assessment into clinical decision-making for elderly CRC patients, as frail individuals are at substantially higher risk for adverse outcomes regardless of the oncologic intervention. These may explain no clear benefit of adding oxaliplatin to 5-fluorouracil in adjuvant setting. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eThis study has several limitations. Firstly, while our study examines associations between postoperative chemotherapy and overall survival across different age groups, we did not directly quantify or compare the relative impact of tumor-specific factors, such as stage or grade, versus patient-specific factors, such as comorbidity burden or age, on survival outcomes. As a result, our conclusions regarding the predominance of non-tumor factors in elderly patients are inferential, rather than directly demonstrated by our data. Secondly, our analysis did not include stratified survival curves or hazard models adjusted for tumor stage or comorbidity indices. Stage-specific survival analysis would allow for a clearer understanding of how the effect of chemotherapy varies within each stage, while comorbidity-adjusted analyses would help isolate the impact of treatment from underlying health status. The lack of these adjustments limits our ability to distinguish whether observed survival differences are primarily driven by cancer progression or by competing risks from other illnesses, particularly in the elderly cohort. Finally, there is a possibility of selection bias in our study population, especially among elderly patients. In clinical practice, patients with significant frailty, multiple comorbidities, or poor performance status are less likely to be offered or to tolerate postoperative chemotherapy. Conversely, those elderly patients who do receive chemotherapy may represent a selectively healthier subgroup, or, alternatively, may be those with more aggressive disease. This confounding by indication could distort the observed association between chemotherapy and survival, making it difficult to determine whether poorer outcomes are due to the treatment itself, the underlying health of the patient, or the biology of more advanced tumors. Without detailed data on performance status, frailty measures, or reasons for treatment selection, this potential bias cannot be fully addressed.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study suggests that, in elderly patients with colorectal cancer, non-tumor factors of comorbidity and frailty may play a dominant role in determining overall survival\u0026mdash;potentially exceeding the impact of tumor-directed treatments like surgery and chemotherapy. As the burden of comorbidity frailty increases with age, its influence on survival becomes more pronounced, especially in early-stage disease, and may mask or outweigh any benefits from adjuvant therapies. However, these findings should be interpreted with caution due to several important limitations. Future research incorporating more detailed clinical data and robust analytical methods is needed to clarify the interplay between tumor characteristics, patient comorbidities, and treatment effects in elderly cancer patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThe authors acknowledge the financial support of the St. Vincent\u0026rsquo;s Hospital, The Catholic University of Korea, Research Institute of Medical Science Foundation (SVHR-BD-2024-01).\u003c/p\u003e\u003cp\u003eCompeting interests\u003c/p\u003e\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eKH prepared and analyzed the data and created the tables and figure. NY, JM, BK, IL interpreted the patient data. NY wrote the main manuscript text. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F: \u003cstrong\u003eGlobal Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries\u003c/strong\u003e. \u003cem\u003eCA Cancer J Clin \u003c/em\u003e2021, \u003cstrong\u003e71\u003c/strong\u003e(3):209-249.\u003c/li\u003e\n\u003cli\u003eMorgan E, Arnold M, Gini A, Lorenzoni V, Cabasag CJ, Laversanne M, Vignat J, Ferlay J, Murphy N, Bray F: \u003cstrong\u003eGlobal burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN\u003c/strong\u003e. \u003cem\u003eGut \u003c/em\u003e2023, \u003cstrong\u003e72\u003c/strong\u003e(2):338-344.\u003c/li\u003e\n\u003cli\u003eO\u0026apos;Sullivan B, Brierley J, Byrd D, Bosman F, Kehoe S, Kossary C, Pi\u0026ntilde;eros M, Van Eycken E, Weir HK, Gospodarowicz M: \u003cstrong\u003eThe TNM classification of malignant tumours-towards common understanding and reasonable expectations\u003c/strong\u003e. \u003cem\u003eLancet Oncol \u003c/em\u003e2017, \u003cstrong\u003e18\u003c/strong\u003e(7):849-851.\u003c/li\u003e\n\u003cli\u003eEng C, Yoshino T, Ru\u0026iacute;z-Garc\u0026iacute;a E, Mostafa N, Cann CG, O\u0026apos;Brian B, Benny A, Perez RO, Cremolini C: \u003cstrong\u003eColorectal cancer\u003c/strong\u003e. \u003cem\u003eLancet \u003c/em\u003e2024, \u003cstrong\u003e404\u003c/strong\u003e(10449):294-310.\u003c/li\u003e\n\u003cli\u003eBoakye D, Walter V, Jansen L, Martens UM, Chang-Claude J, Hoffmeister M, Brenner H: \u003cstrong\u003eMagnitude of the Age-Advancement Effect of Comorbidities in Colorectal Cancer Prognosis\u003c/strong\u003e. \u003cem\u003eJ Natl Compr Canc Netw \u003c/em\u003e2020, \u003cstrong\u003e18\u003c/strong\u003e(1):59-68.\u003c/li\u003e\n\u003cli\u003eRead WL, Tierney RM, Page NC, Costas I, Govindan R, Spitznagel EL, Piccirillo JF: \u003cstrong\u003eDifferential prognostic impact of comorbidity\u003c/strong\u003e. \u003cem\u003eJ Clin Oncol \u003c/em\u003e2004, \u003cstrong\u003e22\u003c/strong\u003e(15):3099-3103.\u003c/li\u003e\n\u003cli\u003eBoakye D, Rillmann B, Walter V, Jansen L, Hoffmeister M, Brenner H: \u003cstrong\u003eImpact of comorbidity and frailty on prognosis in colorectal cancer patients: A systematic review and meta-analysis\u003c/strong\u003e. \u003cem\u003eCancer Treat Rev \u003c/em\u003e2018, \u003cstrong\u003e64\u003c/strong\u003e:30-39.\u003c/li\u003e\n\u003cli\u003eKim HK, Song SO, Noh J, Jeong IK, Lee BW: \u003cstrong\u003eData Configuration and Publication Trends for the Korean National Health Insurance and Health Insurance Review \u0026amp; Assessment Database\u003c/strong\u003e. \u003cem\u003eDiabetes Metab J \u003c/em\u003e2020, \u003cstrong\u003e44\u003c/strong\u003e(5):671-678.\u003c/li\u003e\n\u003cli\u003eMerchant SJ, Nanji S, Brennan K, Karim S, Patel SV, Biagi JJ, Booth CM: \u003cstrong\u003eManagement of stage III colon cancer in the elderly: Practice patterns and outcomes in the general population\u003c/strong\u003e. \u003cem\u003eCancer \u003c/em\u003e2017, \u003cstrong\u003e123\u003c/strong\u003e(15):2840-2849.\u003c/li\u003e\n\u003cli\u003eBaretti M, Rimassa L, Personeni N, Giordano L, Tronconi MC, Pressiani T, Bozzarelli S, Santoro A: \u003cstrong\u003eEffect of Comorbidities in Stage II/III Colorectal Cancer Patients Treated With Surgery and Neoadjuvant/Adjuvant Chemotherapy: A Single-Center, Observational Study\u003c/strong\u003e. \u003cem\u003eClin Colorectal Cancer \u003c/em\u003e2018, \u003cstrong\u003e17\u003c/strong\u003e(3):e489-e498.\u003c/li\u003e\n\u003cli\u003eCai M, Gao Z, Liao J, Jiang Y, He Y: \u003cstrong\u003eFrailty affects prognosis in patients with colorectal cancer: A systematic review and meta-analysis\u003c/strong\u003e. \u003cem\u003eFront Oncol \u003c/em\u003e2022, \u003cstrong\u003e12\u003c/strong\u003e:1017183.\u003c/li\u003e\n\u003cli\u003eMcCleary NJ, Meyerhardt JA, Green E, Yothers G, de Gramont A, Van Cutsem E, O\u0026apos;Connell M, Twelves CJ, Saltz LB, Haller DG\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eImpact of age on the efficacy of newer adjuvant therapies in patients with stage II/III colon cancer: findings from the ACCENT database\u003c/strong\u003e. \u003cem\u003eJ Clin Oncol \u003c/em\u003e2013, \u003cstrong\u003e31\u003c/strong\u003e(20):2600-2606.\u003c/li\u003e\n\u003cli\u003eSanoff HK, Carpenter WR, St\u0026uuml;rmer T, Goldberg RM, Martin CF, Fine JP, McCleary NJ, Meyerhardt JA, Niland J, Kahn KL\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eEffect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years\u003c/strong\u003e. \u003cem\u003eJ Clin Oncol \u003c/em\u003e2012, \u003cstrong\u003e30\u003c/strong\u003e(21):2624-2634.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. Patient demographics and characteristics\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"119%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003eTOTAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 20px;\"\u003e\n \u003cp\u003ePostoperative chemotherapy (in Total)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 20px;\"\u003e\n \u003cp\u003ePostoperative chemotherapy\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ein Age\u0026lt;70 (N=1343)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 27px;\"\u003e\n \u003cp\u003ePostoperative chemotherapy\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;in Age\u0026ge;70 (N=799)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2142 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1197 (55.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e945 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e634 (47.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e709 (52.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e563 (70.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e236 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1273(59.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e701(58.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e572(60.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.3575\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e399(62.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e422(59.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.2002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e302(53.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e150(63.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.0099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e869(40.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e496(41.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e373(39.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e235(37.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e287(40.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e261(46.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e86(36.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e64.24\u0026plusmn;12.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e67\u0026plusmn;12.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e60.74\u0026plusmn;11.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e57.91\u0026plusmn;8.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e56.4\u0026plusmn;9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e77.24\u0026plusmn;5.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e73.77\u0026plusmn;3.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e20-39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e64(2.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e24(2.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e40(4.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e24(3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e40(5.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e40-59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e659(30.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e291(24.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e368(38.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e291(45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e368(51.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e60-69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e620(28.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e319(26.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e301(31.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e319(50.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e301(42.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e70-79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e602(28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e381(31.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e221(23.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e381(67.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e221(93.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026ge;80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e197(9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e182(15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e15(1.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e182(32.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e15(6.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eSocial status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eLow income status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e354(16.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e192(16.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e162(17.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.4951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e111(17.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e124(17.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.9929\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e81(14.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e38(16.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.5346\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eColorectal ICD-10 code\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 28px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eColon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eC18-C19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1633(76.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e899(75.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e734(77.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.1657\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e463(73.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e552(77.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e436(77.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e182(77.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.9206\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eRectum\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eC20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e509(23.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e298(24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e211(22.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e171(26.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e157(22.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e127(22.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e54(22.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eType of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eColectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e808(37.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e478(39.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e330(34.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e216(34.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e243(34.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.991\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e262(46.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e87(36.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.0119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eAnterior resection or Low anterior resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1330(62.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e717(59.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e613(64.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e416(65.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e464(65.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e301(53.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e149(63.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eTotal or subtotal colectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e4(0.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e2(0.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2(0.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2(0.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2(0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eTime from surgery to first chemo (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e96.05\u0026plusmn;265.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e820.73\u0026plusmn;602.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e37\u0026plusmn;21.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e839.49\u0026plusmn;613.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e35.49\u0026plusmn;19.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e803.38\u0026plusmn;599.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e41.54\u0026plusmn;26.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eDeath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e540(25.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e266(22.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e274(28.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e50(7.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e183(25.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e216(38.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e91(38.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.9591\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eFollow-up duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.37\u0026plusmn;2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e5.53\u0026plusmn;2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.16\u0026plusmn;2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e6.26\u0026plusmn;2.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.35\u0026plusmn;2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e4.72\u0026plusmn;2.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.57\u0026plusmn;2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.4921\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMedian (Q1-Q3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.31 (3.35-7.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e5.6 (3.52-7.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e4.96 (3.18-7.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e6.32 (4.38-8.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.22 (3.45-7.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e4.56 (2.67-6.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.23 (2.57-6.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.452\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003eTOTAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 20px;\"\u003e\n \u003cp\u003ePostoperative chemotherapy (in Total)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 20px;\"\u003e\n \u003cp\u003ePostoperative chemotherapy\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ein Age\u0026lt;70 (N=1343)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 27px;\"\u003e\n \u003cp\u003ePostoperative chemotherapy\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;in Age\u0026ge;70 (N=799)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2142 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1197 (55.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e945 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e634 (47.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e709 (52.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e563 (70.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e236 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1273(59.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e701(58.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e572(60.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.3575\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e399(62.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e422(59.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.2002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e302(53.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e150(63.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.0099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e869(40.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e496(41.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e373(39.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e235(37.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e287(40.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e261(46.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e86(36.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e64.24\u0026plusmn;12.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e67\u0026plusmn;12.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e60.74\u0026plusmn;11.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e57.91\u0026plusmn;8.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e56.4\u0026plusmn;9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e77.24\u0026plusmn;5.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e73.77\u0026plusmn;3.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e20-39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e64(2.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e24(2.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e40(4.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e24(3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e40(5.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e40-59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e659(30.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e291(24.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e368(38.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e291(45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e368(51.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e60-69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e620(28.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e319(26.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e301(31.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e319(50.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e301(42.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e70-79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e602(28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e381(31.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e221(23.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e381(67.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e221(93.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026ge;80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e197(9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e182(15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e15(1.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e182(32.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e15(6.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eSocial status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eLow income status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e354(16.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e192(16.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e162(17.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.4951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e111(17.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e124(17.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.9929\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e81(14.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e38(16.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.5346\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eColorectal ICD-10 code\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eColon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eC18-C19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1633(76.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e899(75.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e734(77.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.1657\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e463(73.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e552(77.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e436(77.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e182(77.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.9206\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eRectum\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eC20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e509(23.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e298(24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e211(22.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e171(26.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e157(22.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e127(22.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e54(22.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eType of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eColectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e808(37.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e478(39.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e330(34.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e216(34.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e243(34.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 4px;\"\u003e\n \u003cp\u003e0.991\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e262(46.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e87(36.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.0119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eAnterior resection or Low anterior resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1330(62.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e717(59.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e613(64.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e416(65.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e464(65.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e301(53.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e149(63.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eTotal or subtotal colectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e4(0.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e2(0.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2(0.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2(0.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2(0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eTime from surgery to first chemo (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e96.05\u0026plusmn;265.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e820.73\u0026plusmn;602.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e37\u0026plusmn;21.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e839.49\u0026plusmn;613.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e35.49\u0026plusmn;19.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e803.38\u0026plusmn;599.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e41.54\u0026plusmn;26.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eDeath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e540(25.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e266(22.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e274(28.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e50(7.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e183(25.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e216(38.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e91(38.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.9591\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eFollow-up duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.37\u0026plusmn;2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e5.53\u0026plusmn;2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.16\u0026plusmn;2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e6.26\u0026plusmn;2.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.35\u0026plusmn;2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e4.72\u0026plusmn;2.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.57\u0026plusmn;2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.4921\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003eMedian (Q1-Q3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.31 (3.35-7.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e5.6 (3.52-7.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e4.96 (3.18-7.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e0.0035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e6.32 (4.38-8.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.22 (3.45-7.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e4.56 (2.67-6.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.23 (2.57-6.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e0.452\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2. The mortality risks between postoperative chemotherapy and no chemotherapy groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"711\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003cp\u003ePostoperative chemotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 43px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003eDEATH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 70px;\"\u003e\n \u003cp\u003eDuration, PY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003eIR,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1000 PY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 374px;\"\u003e\n \u003cp\u003eHR (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003eModel 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003eModel 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003ein Total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e1197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e6624.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e40.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1 (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.0002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1 (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e4874.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e56.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1.382 (1.167,1.636)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1.877 (1.572,2.241)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003ein Age \u0026lt;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e634\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e3966.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e12.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1 (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1 (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e709\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e3794.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e48.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e3.762 (2.751,5.146)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e3.831 (2.799,5.242)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003ein Age\u0026ge;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e563\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e2657.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e81.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1 (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.8218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1 (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 64px;\"\u003e\n \u003cp\u003e0.0075\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\n \u003cp\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e1079.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e84.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1.029 (0.805,1.314)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 127px;\"\u003e\n \u003cp\u003e1.437 (1.102,1.874)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eModel 1 Non-adjusted\u003c/p\u003e\n\u003cp\u003eModel 2 Adjusted by sex, age, and income status\u003c/p\u003e\n\u003cp\u003ePY, person-years; IR, Incidence rate; HR, Hazard ratio; CI, Confidence interval\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3. Subgroup analysis on the mortality risks after colorectal cancer treatment\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"111%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003ePostoperative chemotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 9px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003eDEATH (N)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003eDuration, PY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003eIR,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1000-PY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 39px;\"\u003e\n \u003cp\u003eHR (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eModel 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eP for interaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eModel 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP for interaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ein Total\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e701\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3878.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e43.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.8864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.1333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e572\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2891.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e59.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.367(1.105,1.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.705(1.373,2.118)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e496\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2746.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e36.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1982.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e50.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.402(1.062,1.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.231(1.675,2.972)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e20-69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e634\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3966.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e12.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e709\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3794.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e48.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3.75(2.742,5.127)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3.926(2.87,5.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026ge;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e563\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2657.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e81.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1079.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e84.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.031(0.807,1.317)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.117(0.87,1.434)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eIncome status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e1005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e5610.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e39.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.6032\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.4921\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e783\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e4045.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e56.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.409(1.172,1.694)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.927(1.59,2.334)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1013.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e42.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e828.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e53.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.248(0.82,1.899)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.64(1.074,2.505)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ein Age \u0026lt;70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2483.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e16.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.0649\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.0562\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e422\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2210.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e51.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3.137(2.188,4.499)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3.135(2.186,4.496)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1483.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e6.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1584.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e43.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e6.387(3.29,12.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e6.553(3.368,12.748)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eIncome status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e523\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3315.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e11.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.0631\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.0728\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3116.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e50.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e4.311(3.024,6.147)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e4.368(3.062,6.232)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e651.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e18.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e678.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e38.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.076(1.048,4.115)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.156(1.087,4.277)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ein Age \u0026ge;70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1394.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e91.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.5126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.3184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e681.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e86.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e0.948(0.696,1.292)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.313(0.951,1.813)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1263.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e70.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e398.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e80.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.124(0.75,1.684)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.702(1.119,2.589)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eIncome status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2295.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e80.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.2333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e929.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e78.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e0.97(0.74,1.272)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.348(1.01,1.799)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e362.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e85.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1(Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e150.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e119.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.355(0.758,2.423)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.992(1.1,3.609)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eModel 1 Non-adjusted\u003c/p\u003e\n\u003cp\u003eModel 2 adjusted by sex, Age, Income status\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePY, person-years; IR, Incidence rate; HR, Hazard ratio; CI, Confidence interval\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"colorectal neoplasms, frailty, comorbidity, drug therapy, surgical procedures","lastPublishedDoi":"10.21203/rs.3.rs-6884777/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6884777/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eColorectal cancer (CRC) predominantly affects the elderly, with a growing demand for evidence-based treatment strategies in this population. The influence of comorbidities and frailty on survival outcomes following postoperative chemotherapy in elderly CRC patients remains unclear.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e\u003cp\u003eFrom the Korean National Health Insurance database, we analyzed 200,000 randomly sampled colorectal cancer patients (C18-20) diagnosed between 2009\u0026ndash;2016. Patients under 20, those with inflammatory bowel disease, preoperative chemotherapy (except neoadjuvant chemoradiotherapy for rectal cancer), missing data, or death within 6 months post-surgery were excluded. Cox proportional hazards models estimated hazard ratios (HRs) for overall survival, adjusted for demographic factors. Subgroup and interaction analyses assessed effect modification by age, sex, and income. Incidence rates were reported per 1,000 person-years.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cp\u003eAmong 2,142 patients, 44.2% received postoperative chemotherapy. Chemotherapy recipients were younger and had lower overall mortality in the unadjusted analysis. However, after adjustment, postoperative chemotherapy was associated with an increased risk of mortality (adjusted hazard ratio [HR] 1.44, 95% CI: 1.10\u0026ndash;1.87) in patients aged\u0026thinsp;\u0026ge;\u0026thinsp;70 years. The impact of chemotherapy on survival was more pronounced in younger patients. Comorbidity and frailty emerged as significant prognostic factors, potentially outweighing the benefits of adjuvant therapy in the elderly.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eIn elderly CRC patients, comorbidity and frailty may play a dominant role in determining overall survival, potentially exceeding the impact of tumor-directed treatments such as postoperative chemotherapy. These findings highlight the need for comprehensive geriatric assessment and individualized treatment planning in this population.\u003c/p\u003e","manuscriptTitle":"Overall Survival Following Radical Surgery and Postoperative Chemotherapy in Colorectal Cancer Patients Aged ≥70 Years: A Population-Based Retrospective Cohort Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-04 10:36:39","doi":"10.21203/rs.3.rs-6884777/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-05T02:35:39+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-30T21:15:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"323982903346255892124168282055215360818","date":"2025-07-30T21:04:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-30T07:29:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"74464693712150117731835910118138181743","date":"2025-07-30T05:47:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-29T20:13:26+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-28T03:30:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-23T06:16:25+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-23T06:13:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cancer","date":"2025-06-13T05:12:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b6745a55-333c-414d-a4be-ed22cda79ed7","owner":[],"postedDate":"August 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-08T16:05:22+00:00","versionOfRecord":{"articleIdentity":"rs-6884777","link":"https://doi.org/10.1186/s12885-025-14863-w","journal":{"identity":"bmc-cancer","isVorOnly":false,"title":"BMC Cancer"},"publishedOn":"2025-09-02 15:58:04","publishedOnDateReadable":"September 2nd, 2025"},"versionCreatedAt":"2025-08-04 10:36:39","video":"","vorDoi":"10.1186/s12885-025-14863-w","vorDoiUrl":"https://doi.org/10.1186/s12885-025-14863-w","workflowStages":[]},"version":"v1","identity":"rs-6884777","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6884777","identity":"rs-6884777","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}