OBJECTIVES Colorectal cancer (CRC) patients are considered to have been cured when the mortality rate of individuals with the disease returns to the same level as expected in the general population. This study aimed to assess the impact of various risk factors on the cure fraction of CRC patients using a real dataset of Iranian CRC patients with a non-mixture non-parametric cure model.
METHODS
This study was conducted on the medical records of 512 patients who were definitively diagnosed with CRC at Taleghani Hospital, Tehran, Iran from 2001 to 2007. A non-mixture non-parametric cure rate model was applied to the data after using stepwise selection to identify the risk factors of CRC.
RESULTS
For non-cured cases, the mean survival time was 1,243.83 days (95% confidence interval [CI], 1,174.65 to 1,313.00) and the median survival time was 1,493.00 days (95% CI, 1,398.67 to 1,587.33). The 1- and 3-year survival rates were 92.9% (95% CI, 91.0 to 95.0) and 73.4% (95% CI, 68.0 to 79.0), respectively. Pathologic stage T1 of the primary tumor (estimate=0.58; p=0.013), a poorly differentiated tumor (estimate=1.17; p<0.001), a body mass index (BMI) between 18.6 and 24.9 kg/m2 (estimate=−0.60; p=0.04), and a BMI between 25.0 and 29.9 kg/m2 (estimate=−1.43; p<0.001) had significant impacts on the cure fraction of CRC in the multivariate analysis. The proportion of cured patients was 64.1% (95% CI, 56.7 to 72.4).
CONCLUSIONS
This study found that the pathologic stage of the primary tumor, tumor grade, and BMI were potential risk factors that had an impact on the cure fraction. A non-mixture non-parametric cure rate model provides a flexible framework for accurately determining the impact of risk factors on the long-term survival of patients with CRC.
Summary
Citations
Citations to this article as recorded by
Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis Nerea Becerra‐Tomás, Georgios Markozannes, Margarita Cariolou, Katia Balducci, Rita Vieira, Sonia Kiss, Dagfinn Aune, Darren C. Greenwood, Laure Dossus, Ellen Copson, Andrew G. Renehan, Martijn Bours, Wendy Demark‐Wahnefried, Melissa M. Hudson, Anne M. Ma International Journal of Cancer.2024; 155(3): 400. CrossRef
Assessment of prognostic factors in long-term survival of male and female patients with colorectal cancer using non-mixture cure model based on the Weibull distribution Mehdi Azizmohammad Looha, Elaheh Zarean, Fatemeh Masaebi, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali Surgical Oncology.2021; 38: 101562. CrossRef
Actual survival after resection of primary colorectal cancer: results from a prospective multicenter study Inge van den Berg, Robert R. J. Coebergh van den Braak, Jeroen L. A. van Vugt, Jan N. M. Ijzermans, Stefan Buettner World Journal of Surgical Oncology.2021;[Epub] CrossRef