SP 3.15 Factors Associated with Three-Year Mortality Following Surgical Resection for Colon Cancer: A Retrospective Cohort Study
Mohammed Ahmed, Ahmed Kassem, Erik-Alexandru Turi, Arifur Rehman, Ahmed Alwetaidy, Khalid HureibiAbstract
Introduction
Three-year mortality following surgical resection for colon cancer remains significant, particularly in non-tertiary settings. Identifying factors associated with medium-term mortality is essential for risk stratification and optimisation of peri-operative and oncological care. This study evaluated factors associated with three-year mortality following colon cancer resection in a district general hospital.
Methods
A retrospective cohort study was conducted of patients undergoing surgical resection for colon cancer at a single district general hospital. Demographic, clinical, pathological, operative, and follow-up data were collected. Univariable analyses assessed associations with three-year mortality. Multivariable logistic regression identified independent predictors using two models: a baseline model including pre-operative and pathological variables, and a comprehensive model incorporating post-operative factors. Adjusted odds ratios (OR) with 95% confidence intervals (CI) are reported.
Results
In total, 319 patients were included, with 75 deaths within three years. Venous invasion (adjusted OR 4.96) and higher ASA grade (adjusted OR 1.92 per grade) were independently associated with increased mortality in the baseline model. In the comprehensive model, disease recurrence was the strongest predictor of mortality (adjusted OR 10.04). Venous invasion, nodal stage, higher ASA grade, and hospital readmission remained independently associated with increased mortality, while adjuvant chemotherapy was associated with reduced mortality (adjusted OR 0.19).
Conclusion
Three-year mortality after colon cancer resection in a district general hospital is driven mainly by tumour biology and patient physiological status, with recurrence exerting the greatest impact on survival.