The prognoses and postoperative outcomes of patients with both colorectal cancer and liver cirrhosis based on a nationwide cohort in Korea
- Authors
- Shin, Nari; Han, Eon Chul; Won, Sungho; Ryoo, Seung-Bum; Choe, Eun Kyung; Park, Byung Kwan; Park, Kyu Joo
- Issue Date
- Aug-2020
- Publisher
- KOREAN SURGICAL SOCIETY
- Keywords
- Colorectal neoplasms; Complication; Liver cirrhosis; Ontological results
- Citation
- ANNALS OF SURGICAL TREATMENT AND RESEARCH, v.99, no.2, pp 82 - 89
- Pages
- 8
- Journal Title
- ANNALS OF SURGICAL TREATMENT AND RESEARCH
- Volume
- 99
- Number
- 2
- Start Page
- 82
- End Page
- 89
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/53562
- DOI
- 10.4174/astr.2020.99.2.82
- ISSN
- 2288-6575
2288-6796
- Abstract
- Purpose: The management of patients with colorectal cancer (CRC) who have liver cirrhosis (LC) requires a thorough understanding of both diseases; however, the prognoses and postoperative outcomes of such patients remain understudied. We investigated the effect of LC on surgical and oncologic outcomes in patients with CRC, and identified prognostic factors. Methods: We analyzed 453 patients with CRC and LC (CRC-LC group), 906 with CRC only (CRC group), 906 with LC only (LC group), and 1,812 healthy subjects using health insurance claim data (2008-2013). Results: The CRC-LC group had a higher frequency of intensive care unit admission than the CRC group; there were no differences between the 2 groups in terms of early and late postoperative small bowel obstruction and incisional hernia. However, the 30-day, 60-day, and 90-day mortality rates were all significantly higher in the CRC-LC group. The higher Chartson comorbidity index (hazard ratio (HR), 1.127) and the lower socioeconomic status (HR, 0.985) were significant worse predictors of 5-year survival. Patients with underlying LC had a significantly higher HR in both the advanced CRC (HR, 1.858) and nonadvanced CRC (HR, 1.799) subgroups. However, the nonadvanced CRC subgroup showed a lower HR than the LC group (HR, 0.730). Conclusion: Patients with CRC who had underlying LC had a lower survival rate than did those without LC, although the incidence rates of postoperative complications were not significantly different. The presence of LC was associated with a significantly lower survival rate regardless of CRC presence.
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