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KMID : 1038520150370010005
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Epidemiology and Health
2015 Volume.37 No. 1 p.5 ~ p.0
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Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?
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Suan Mohd Azri Mohd
Tan Wei Leong
Soelar Shahrul Aiman
Ismail Ibtisam
Hassan Muhammad Radzi Abu
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Abstract
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OBJECTIVES: The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma.
METHODS: Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorectal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intestinal obstruction. The p-values<0.05 were considered to indicate statistical significance. Simple Cox proportional hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer.
RESULTS: Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008).
CONCLUSIONS: The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.
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KEYWORD
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Carcinoma, Colorectal neoplasm, Intestinal obstruction, Prognosis
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