Preoperative Prognostic Factors of Colorectal Cancer in Patients from Central China: A Retrospective Observational Study

Qilin Fan,1,2,* Min Jin,2– 4,* Jun Fan,5 Feng Wen,1 Weitian Xu,1 Hongli Liu2– 4 1Department of Gastroenterology, General Hospital of Central Theater Command, Wuhan, Hubei, People’s Republic of China; 2Hubei Province Key Laboratory of Precision Radiation Oncology, Wuhan, Hubei, People’s Republic of China; 3Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 4Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 5Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongli Liu, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China, Email [email protected] Weitian Xu, Department of Gastroenterology, General Hospital of Central Theater Command, Wuhan, Hubei, People’s Republic of China, Email [email protected]: This study aimed to investigate the clinicopathological characteristics and identify prognostic factors influencing overall survival (OS) in colorectal cancer (CRC) patients from central China.Patients and Methods: We conducted a retrospective analysis of clinicopathologic data obtainable at the preoperative decision point from 1452 patients with pathologically confirmed CRC who underwent surgical resection between January 2015 and December 2017 at the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, in central China. Associations between clinicopathological variables and OS were evaluated using independent sample tests, Kaplan–Meier survival analysis, and Log rank tests. A Cox proportional hazards model was employed to identify independent predictors of OS.Results: Of 1452 patients, 58.9% were male and 41.1% female (ratio 1.43:1). Multivariate logistic regression identified age, tumor differentiation, preoperative CEA, and metastasis as independent mortality predictors (all P ≤ 0.01; Table 1). A univariate analysis of this predominantly rectal-cancer cohort (51.9%) revealed that numerous clinicopathological variables, including age, tumor size, grade, tumor deposits, perineural and vascular invasion, nodal status, surgical margins, clinical stage, primary site, preoperative CEA, treatment modality, distant metastasis, and recurrence, were each significantly associated with overall survival (Table 2). In the overall cohort, age ≥ 75 years (OR = 3.812), poor differentiation (OR = 2.590), elevated CEA (OR = 4.594), and liver metastasis (OR = 4.370) were independently associated with higher mortality (all P ≤ 0.045; Table 3). Subgroup analyses (Table 4) showed that in colon cancer, age ≥ 75 years (OR = 4.961, P = 0.001) and metastasis (OR = 37.029, P