Survival and prognostic factors predicting outcomes of patients with primary non-Metastatic colorectal cancer who have not had curative intervention

Abstract

Background: The natural progression and life expectancy of patients following a diagnosis of treatable colorectal cancer who receive only symptomatic treatment, nonoperative palliative therapy, or noncurative surgical interventions are relatively unknown. Objectives: The objective of this retrospective study was to examine the survival of patients following a diagnosis of primary nonmetastatic colorectal cancer who did not undergo major surgery for the purpose of curative treatment. Design: A retrospective observational study. Study Settings: Department of Colorectal Surgery, King's College Hospital, London. Patient and Methods: A retrospective study of patients with stages I–III colorectal cancer who had not undergone noncurative surgery, palliative chemotherapy, or radiotherapy between 2012 and 2019 was conducted. Multivariate and univariate analyses were used to evaluate the prognostic factors associated with overall survival (OS). Main Outcome Measure: OS. Sample Size: A total of 78 patients. Results: A total of 78 patients were enrolled in this study. The median survival rate was 296 days or 9.7 months, and the mean survival rate was 385 days (15–1894 days). The 1- and 2-year OS rates were 37.2% and 3.8%, respectively. Univariate analysis revealed that three parameters were statistically significant for OS with a significant correlation with performance status (PS) (P = 0.004), tumor stage (pT) (P = 0.030), and lymph node metastasis (pN) (P = 0.001). Multivariate analysis revealed that pN2 (hazard ratio: 2.19, 95% confidence index: -1.1–4.4) and PS 3 and 4 (hazard ratio: 0.525, 95% confidence index: 0.3–1.0, P = 0.026) were prognostic factors associated with OS. Conclusion: Operable colorectal cancer patients without surgical resection have an OS rate of <1 year; a higher T and N stage is associated with adverse prognosis. Limitations: Our study is limited by its retrospective nature and small sample size. In addition, patients underwent various palliative interventions based on their unique clinical, pathological, and social needs. Conflict of Interest: The authors have no conflict of interest to declare.