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. 2022 Sep 5;10(9):1693.
doi: 10.3390/healthcare10091693.

The Prediction of Survival Outcome and Prognosis Factor in Association with Comorbidity Status in Patients with Colorectal Cancer: A Research-Based Study

Hafeez Afolabi  1 , Salzihan Md Salleh  2 , Zaidi Zakaria  1 , Ewe Seng Ch'ng  3 , Siti Norasikin Mohd Nafi  4 , Ahmad Aizat Bin Abdul Aziz  5 , Sameer Badri Al-Mhanna  6 , Yusuf Wada  7 , Abdulwali Sabo Abdulrahman  8
Affiliations

The Prediction of Survival Outcome and Prognosis Factor in Association with Comorbidity Status in Patients with Colorectal Cancer: A Research-Based Study

Hafeez Afolabi et al. Healthcare (Basel). .

Abstract

Colorectal carcinoma (CRC) is rising exponentially in Asia, representing 11% of cancer worldwide. This study analysed the influence of CRC on patients’ life expectancy (survival and prognosis factors) via clinicopathology data and comorbidity status of CRC patients. Methodology: A retrospective study performed in HUSM using clinical data from the Surgery unit from 2015 to 2020. The demographic and pertinent clinical data were retrieved for preliminary analyses (data cleansing and exploration). Demographics and pathological characteristics were illustrated using descriptive analysis; 5-year survival rates were calculated using Kaplan−Meier methods; potential prognostic variables were analysed using simple and multivariate logistic regression analysis conducted via the Cox proportional hazards model, while the Charlson Comorbidity Scale was used to categorize patients’ disease status. Results: Of a total of 114 CRC patients, two-thirds (89.5%) were from Malay tribes, while Indian and Chinese had 5.3% each. The 50−69.9 years were the most affected group (45.6%). Overall, 40.4% were smokers (majorly male (95.7%)), 14.0% ex-smokers, and 45.6% non-smokers (p-value = 0.001). The Kaplan−Meier overall 5-year median survival time was 62.5%. From the outcomes, patients who were male and >70 years had metastasis present, who presented with per rectal bleeding and were classified as Duke C; and who has tumour in the rectum had the lowest survival rate. Regarding the prognosis factors investigated, “Gender” (adjusted hazard ratio (HR): 2.62; 95% CI: 1.56−7.81, p-value = 0.040), “Presence of metastases” (HR: 3.76; 95% CI: 1.89−7.32, p-value = 0.010), “Metastasis site: Liver” (HR: 5.04; 95% CI: 1.71−19.05, p-value = 0.039), “Lymphovascular permeation” (HR: 2.94; 95% CI: 1.99−5.92, p-value = 0.021), and “CEA-level” (HR: 2.43; 95% CI: 1.49−5.80, p-value = 0.001) remained significant in the final model for multiple Cox proportional hazard regression analyses. There was a significant mean association between tumour grades and the patient’s comorbidity status. Conclusions: Histopathological factors (gender, metastases presence, site of metastases, CEA level, and lymphovascular permeation) showed the best prognosis-predicting factors in CRC.

Keywords: colorectal cancer; prognosis factors; survival factors.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Mechanism and prognosis factors influence the pathogenesis of colorectal cancer.
Figure 2
Figure 2
Overall survival percentage score as reported for the different countries in comparison with the present study’s percentage score.
See this image and copyright information in PMC

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