The impact of comorbidity on the overall survival and the cause of death in patients after colorectal cancer resection.
BACKGROUND
Retrospective investigation to identify associations between certain patient characteristics and survival in 531 patients with resected colorectal cancer (CRC). Special reference is given to a standardized comorbidity.


METHODS
To compare different levels of exposure we determined hazard ratios (HR) in Cox proportional hazards models for survival times and odds ratios (OR) in logistic regression models.


RESULTS
Overall survival was associated with tumor stages (III+IV vs. I+II; HR 7.48), tumor differentiation (low vs. high; HR 1.84), blood transfusions (>2 vs. < or =2; HR 1.88), and comorbidity (Charlson Comorbidity Index >2 vs. < or =2; HR 1.77). Low tumor stage (I+II vs. III+IV; OR 11.1), elevated Charlson Comorbidity Index (>2 vs. < or =2; OR 3.83), and longer ICU stay (>2 days vs. < or =2 days; OR 3.40) more frequently lead to non-cancer-related death than to cancer-related death.


CONCLUSIONS
Standardized comorbidity should be considered as a factor in survival studies of CRC.
Department of Pathology, Im Neuenheimer Feld 220/221, University of Heidelberg, Germany. ralf_rieker@med.uni-heidelberg.de
Ralf Joachim
RJ
Rieker
Eva
E
Hammer
Roland
R
Eisele
Eberhardt
E
Schmid
Josef
J
Högel
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis