[Morbidity, mortality and analysis of prognostic factors for colorectal cancer]. / Morbidität, Mortalität und Analyse prognostischer Faktoren beim kolorektalen Karzinom.

ABSTRACT

BACKGROUND: This study analyzed morbidity, mortality and prognostic factors for patient survival in a single center collective of patients with colorectal cancer and a high follow-up rate. MATERIAL AND METHODS: A total of 698 consecutive patients were included in this study. Data were collected prospectively. Descriptive and survival analyses as well as Cox regression analyses were performed to identify factors for morbidity, mortality and prognostic factors for survival. RESULTS: At presentation 78.8 % of the colon cancer patients and 83.5 % of rectal cancer patients showed symptomatic disease and 6.5 % of patients underwent an emergency procedure. Mortality was 3.6 %, morbidity was 42.7 % and 4.3 % of patients developed an anastomotic leakage with the need of reoperation. In spite of the regular application of a fast-track program, 10 % of patients had a prolonged duration of bowel paralysis. In patients with colon cancer there were no differences between overall survival (OAS) and disease-free survival, whereas there was a significant difference in patients with rectal cancer. The mean survival of all patients was 65.39 ± 1.722 months. The ASA score, cardiovascular disease, number of metastatic lymph nodes, lymph node ratio, residual tumor and general or surgery-associated complications were strongly independent influencing factors on OAS. A Cox analysis revealed age at diagnosis and microscopic residual tumor (TNM R1) as highly significant influencing factors on OAS. Other significant factors of influence on OAS were development of general or surgery-associated complications and the presence of cardiovascular diseases. CONCLUSION: Cardiovascular disease leads to a higher morbidity rate whereas age, International Union Against Cancer (UICC) stage, R-status, lymphatic spread and occurrence of complications are important prognostic factors for survival.