Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?

Mohd Suan, Mohd Azri; Tan, Wei Leong; Soelar, Shahrul Aiman; Ismail, Ibtisam; Abu Hassan, Muhammad Radzi

Abstract

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.