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Analysis of the prognostic factors affecting 5-year colorectal cancer survival rates in Makassar, Eastern Indonesia: a retrospective cohort study
Arsyad A.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: The 5-year survival rate for colorectal cancer (CRC) in Italy is 47%. Variations in patient survival rates have been linked to different prognostic variables. This study examined the relationship between several prognostic variables and 5-year CRC survival rates at the Dr. Wahidin Sudirohusodo General Hospital Makassar (RSWS) in Makassar, Indonesia.METHODS: The study included all patients who underwent gastrointestinal surgery for CRC from 2012 to 2016. Data on prognostic factors were collected from medical records for 513 patients. The 5-year survival rates were analyzed using the Kaplan-Meier method and log-rank tests and extended with multivariate Cox regression analysis.RESULTS: Log-rank analysis showed associations between 5-year survival rate and gender (P=0.900), age (P=0.012), tumor location (P=0.036), tumor stage (P=0.003), histopathology (P=0.020), differentiation (P=0.033), carcinoembryonic antigen (CEA) ratio (P=0.010), neutrophil-to-lymphocyte ratio (P=0.146), chemotherapy (P=0.026), and radiotherapy (P=0.464). The Cox regression found that the independent predictors of poor 5-year CRC survival were perioperative CEA ratio >0.5 (hazard ratio [HR]=2.47), stage (HR=1.89), age >50 years (HR=1.72), and mucinous histopathology (HR=1.63).CONCLUSIONS: The overall 5-year survival rate for CRC was 36.5%. Perioperative CEA ratio, cancer stage, age >50 years, and mucinous histopathology were associated with the lowest survival rates. In Makassar, screening is essential for the early diagnosis of CRC.