Predictors of Survival Among Colorectal Cancer Patients in a Low Incidence Area

Nahla Azzam, 1 Yazed AlRuthia, 2, 3 Othman Alharbi, 1 Abdulrahman Aljebreen, 1 Majid Almadi, 1, 4 Maryam Alarfaj, 5 Khalid Alsaleh, 6 Abdulaziz Almasoud, 1 Muhannad Alsharidah, 1 Sarah Alseneidi, 1 Fatimah Alali, 1 Malak Alalwan 1 1Gastroenterology Division, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Division of Gastroenterology, The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada; 5Department of Pharmaceutical Care, King Saud University Medical City, Riyadh, Saudi Arabia; 6Department of Hematology/Oncology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Yazed AlRuthiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaTel +966114677483Fax +966114677480Email yazeed@ksu.edu.saBackground: Colorectal cancer is the third most common malignancy in Saudi Arabia. The best therapeutic regimen for colorectal cancer is a matter of ongoing debate and data on its treatment in Saudi Arabia are limited.Purpose: The objective of this study was to explore the predictors of survival and to compare the risk of mortality among colorectal cancer patients treated with different therapeutic modalities.Patients and Methods: The study utilized data from the electronic colorectal cancer registry of a university-affiliated tertiary care hospital. The Kaplan-Meier survival analysis was used to estimate the survival rates over 36 months of follow-up across rectal and colon cancer patients as well as different sociodemographic and medical characteristics. Bivariate and multiple Cox proportional-hazards regressions were conducted to estimate the risk of mortality among rectal and colon cancer patients undergoing different treatments.Results: The number of patients in the registry who were followed up for 36 months was 143 patients. The majority of patients had colon cancer (74.13%). Rectal cancer patients had generally better survival estimates compared to their colon cancer counterparts. Colon cancer patients treated with chemotherapy had a significantly lower risk of mortality controlling for the use of surgery, radiotherapy, and other variables including age, gender, stage of cancer, and family history of colorectal cancer (HR=0.33; P=0.03). Additionally, colon cancer patients with a family history of colorectal cancer had significantly higher risk of mortality (HR=3.40; P=0.02).Conclusion: The findings of this study highlight the value of chemotherapy in managing colon cancer patients.Keywords: colorectal cancer, surgery, chemotherapy, survival, Saudi Arabia