Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of Survival
Those with cirrhosis who develop colorectal cancer (CRC) are an understudied group who may tolerate treatments poorly and are at risk of worse outcomes. This is a retrospective cohort study of 842 individuals from Ontario, Canada, with a pre-existing diagnosis of cirrhosis who underwent surgery for...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/30/11/690 |
| _version_ | 1797459591312703488 |
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| author | Sunil Patel Kelly Brennan Lisa Zhang Maya Djerboua Sulaiman Nanji Shaila Merchant Jennifer Flemming |
| author_facet | Sunil Patel Kelly Brennan Lisa Zhang Maya Djerboua Sulaiman Nanji Shaila Merchant Jennifer Flemming |
| author_sort | Sunil Patel |
| collection | DOAJ |
| description | Those with cirrhosis who develop colorectal cancer (CRC) are an understudied group who may tolerate treatments poorly and are at risk of worse outcomes. This is a retrospective cohort study of 842 individuals from Ontario, Canada, with a pre-existing diagnosis of cirrhosis who underwent surgery for CRC between 2009 and 2017. Practice patterns, overall survival, and short-term morbidity and mortality were assessed. The most common cirrhosis etiology was non-alcoholic fatty liver disease (NAFLD) (52%) and alcohol-associated liver disease (29%). The model for end-stage liver disease score (MELD-Na) was available in 42% (median score of 9, IQR7-11). Preoperative radiation was used in 62% of Stage II/III rectal cancer patients, while postoperative chemotherapy was used in 42% of Stage III colon cancer patients and 38% of Stage II/III rectal cancer patients. Ninety-day mortality following surgery was 12%. Five-year overall survival was 53% (by Stages I–IV, 66%, 55%, 50%, and 11%, respectively). Those with alcohol-associated cirrhosis (HR 1.8, 95% CI 1.5–2.2) had lower survival than those with NAFLD. Those with a MELD-Na of 10+ did worse than those with a lower MELD-Na score (HR 1.9, 95% CI 1.4–2.6). This study reports poor survival in those with cirrhosis who undergo treatment for CRC. Caution should be taken when considering aggressive treatment. |
| first_indexed | 2024-03-09T16:54:33Z |
| format | Article |
| id | doaj.art-380c8348ac804b579fcbe4738bde6448 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T16:54:33Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-380c8348ac804b579fcbe4738bde64482023-11-24T14:37:03ZengMDPI AGCurrent Oncology1198-00521718-77292023-10-0130119530954110.3390/curroncol30110690Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of SurvivalSunil Patel0Kelly Brennan1Lisa Zhang2Maya Djerboua3Sulaiman Nanji4Shaila Merchant5Jennifer Flemming6Department of Surgery, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Surgery, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Surgery, Ottawa University, Ottawa, ON K1H 8L6, CanadaICES Queens, Kingston, ON K7L 3L4, CanadaDepartment of Surgery, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Surgery, Queen’s University, Kingston, ON K7L 2V7, CanadaCancer Care and Epidemiology, Queens Cancer Research Institute, Kingston, ON K7L 3N6, CanadaThose with cirrhosis who develop colorectal cancer (CRC) are an understudied group who may tolerate treatments poorly and are at risk of worse outcomes. This is a retrospective cohort study of 842 individuals from Ontario, Canada, with a pre-existing diagnosis of cirrhosis who underwent surgery for CRC between 2009 and 2017. Practice patterns, overall survival, and short-term morbidity and mortality were assessed. The most common cirrhosis etiology was non-alcoholic fatty liver disease (NAFLD) (52%) and alcohol-associated liver disease (29%). The model for end-stage liver disease score (MELD-Na) was available in 42% (median score of 9, IQR7-11). Preoperative radiation was used in 62% of Stage II/III rectal cancer patients, while postoperative chemotherapy was used in 42% of Stage III colon cancer patients and 38% of Stage II/III rectal cancer patients. Ninety-day mortality following surgery was 12%. Five-year overall survival was 53% (by Stages I–IV, 66%, 55%, 50%, and 11%, respectively). Those with alcohol-associated cirrhosis (HR 1.8, 95% CI 1.5–2.2) had lower survival than those with NAFLD. Those with a MELD-Na of 10+ did worse than those with a lower MELD-Na score (HR 1.9, 95% CI 1.4–2.6). This study reports poor survival in those with cirrhosis who undergo treatment for CRC. Caution should be taken when considering aggressive treatment.https://www.mdpi.com/1718-7729/30/11/690cirrhosiscolorectal cancercancer treatmentsurvivalmortality |
| spellingShingle | Sunil Patel Kelly Brennan Lisa Zhang Maya Djerboua Sulaiman Nanji Shaila Merchant Jennifer Flemming Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of Survival Current Oncology cirrhosis colorectal cancer cancer treatment survival mortality |
| title | Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of Survival |
| title_full | Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of Survival |
| title_fullStr | Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of Survival |
| title_full_unstemmed | Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of Survival |
| title_short | Colorectal Cancer in Individuals with Cirrhosis: A Population-Based Study Assessing Practice Patterns, Outcomes, and Predictors of Survival |
| title_sort | colorectal cancer in individuals with cirrhosis a population based study assessing practice patterns outcomes and predictors of survival |
| topic | cirrhosis colorectal cancer cancer treatment survival mortality |
| url | https://www.mdpi.com/1718-7729/30/11/690 |
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