Exploring the Clinical Characteristics and Survival Outcomes in Colorectal Cancer Patients in Hatyai Hospital: A Retrospective Cohort Study
DOI:
https://doi.org/10.59796/jcst.V15N3.2025.123Keywords:
clinical characteristic, colorectal cancer, early diagnosis, electronic medical record, survival analysisAbstract
Colorectal cancer (CRC) is considered a significant public health concern worldwide, with substantial morbidity and mortality rates. In Thailand, several campaigns have been implemented to address this issue, such as the establishment of local treatment centers. The Cancer Center of Hatyai Hospital (CCHH) is the latest cancer center affiliated with a tertiary public hospital in the southernmost part of Thailand. However, a systematic assessment of cancer treatment outcomes, including those for CRC patients, has yet to be conducted. Therefore, the current study utilized a retrospective analysis approach to elucidate the survival probability of CRC patients treated at CCHH. A secondary data analysis was conducted using electronic medical records (EMRs), and the selected data were validated and filtered by a certified oncologist and pharmacist. Time-to-event analysis was used to model survival probability across subgroups, and visualized using Kaplan-Meier (KM) plots. Additionally, restricted mean survival time (RMST) analysis was performed to estimate the 3-year survival time of this patient cohort, with an estimated survival time of 24.8 months. The univariate Cox proportional hazards (PH) model was used as an exploratory analysis to identify the influence of clinical variables on survival outcomes. Subsequently, a multivariable Cox PH model was constructed with a set of selected variables. T2 tumor status, the presence of distant metastasis, ECOG score of 4, and poorly differentiated tumor were identified as the strongest predictors of reduced survival among the included variables. As such, this study provides practical insights based on real-world data regarding cancer survivorship and the survival outcomes of CRC patients treated at a public hospital. Additionally, it offers a snapshot of the recent implementation of an early diagnosis campaign.
References
Ali-Gombe, M., Mustapha, M. I., Folasire, A., Ntekim, A., & Campbell, O. B. (2021). Pattern of survival of breast cancer patients in a tertiary hospital in South West Nigeria. Ecancermedicalscience, 15, Article 1192. https://doi.org/10.3332/ecancer.2021.1192
Grimberg, F., Asprion, P. M., Schneider, B., Miho, E., Babrak, L., & Habbabeh, A. (2021). The real-world data challenges radar: a review on the challenges and risks regarding the use of real-world data. Digital Biomarkers, 5(2), 148-157. https://doi.org/10.1159/000516178
Haus, R., Janssen, S., Schild, S. E., & Rades, D. (2020). Eastern cooperative oncology group performance score is associated with survival after radiotherapy of bone metastases from prostate cancer. in vivo, 34(2), 679-682. https://doi.org/10.21873/invivo.11823
Kittrongsiri, K., Wanitsuwan, W., Prechawittayakul, P., Sangroongruangsri, S., Cairns, J., & Chaikledkaew, U. (2020). Survival analysis of colorectal cancer patients in a Thai hospital-based cancer registry. Expert Review of Gastroenterology & Hepatology, 14(4), 291-300. https://doi.org/10.1080/17474124.2020.1740087
Laohavinij, S., Maneechavakajorn, J., & Techatanol, P. (2010). Prognostic factors for survival in colorectal cancer patients. Journal of the Medical Association of Thailand, 93(10), 1156–1166.
Le, D. D., Van Vo, T., & Sarakarn, P. (2021). Overall survival rate of Vietnamese patients with colorectal cancer: A hospital-based cohort study in the central region of Vietnam. Asian Pacific Journal of Cancer Prevention: APJCP, 22(11), 3569–3575. https://doi.org/10.31557/APJCP.2021.22.11.3569
Li, X., Zhou, Y., Luo, Z., Gu, Y. A., Chen, Y., Yang, C., ... & Zhao, G. (2019). The impact of screening on the survival of colorectal cancer in Shanghai, China: A population based study. BMC Public Health, 19, 1-9. https://doi.org/10.1186/s12889-019-7318-8
Lohsiriwat, V., Chaisomboon, N., & Pattana-Arun, J. (2020). Current colorectal cancer in Thailand. Annals of Coloproctology, 36(2), 78-82. https://doi.org/10.3393/ac.2020.01.07
Mabuchi, S., Matsumoto, Y., Isohashi, F., Yoshioka, Y., Ohashi, H., Morii, E., ... & Kimura, T. (2011). Pretreatment leukocytosis is an indicator of poor prognosis in patients with cervical cancer. Gynecologic Oncology, 122(1), 25-32. https://doi.org/10.1016/j.ygyno.2011.03.037
Modi, N. D., Sorich, M. J., Rowland, A., Logan, J. M., McKinnon, R. A., Kichenadasse, G., ... & Hopkins, A. M. (2020). A literature review of treatment-specific clinical prediction models in patients with breast cancer. Critical Reviews in Oncology/Hematology, 148, Article 102908. https://doi.org/10.1016/j.critrevonc.2020.102908
Moghimi-Dehkordi, B., & Safaee, A. (2012). An overview of colorectal cancer survival rates and prognosis in Asia. World Journal of Gastrointestinal Oncology, 4(4), 71-75. https://doi.org/10.4251/wjgo.v4.i4.71
Monkhan, N., Phimha, S., Prasit, N., Senahad, N., & Pinsuwan, C. (2023). Colorectal cancer survival in Thailand. International Journal of Public Health Asia Pacific, 2(3), 1-8. https://doi.org/10.62992/ijphap.v2i3.36
Muhamad, N. A., Ma’amor, N. H., Rosli, I. A., Leman, F. N., Abdul Mutalip, M. H., Chan, H. K., ... & Abu Hassan, M. R. (2023). Colorectal cancer survival among Malaysia population: data from the Malaysian National Cancer Registry. Frontiers in Oncology, 13, Article 1132417. https://doi.org/10.3389/fonc.2023.1132417
Olyani, S., Ebrahimipour, H., Taraghdari, M. M., Jamali, J., & Peyman, N. (2023). Colorectal Cancer awareness and related factors among adults attending primary Healthcare in North-Eastern of Iran: a cross-sectional study. Journal of Research in Health Sciences, 23(3), Article e00589. https://doi.org/10.34172/jrhs.2023.124
Pawar, A., Chowdhury, O. R., & Salvi, O. (2022). A narrative review of survival analysis in oncology using R. Cancer Research, Statistics, and Treatment, 5(3), 554-561. https://doi.org/10.4103/crst.crst_230_22
Phimha, S., Promthet, S., Suwanrungruang, K., Chindaprasirt, J., Bouphan, P., Santong, C., & Vatanasapt, P. (2019). Health insurance and colorectal cancer survival in Khon Kaen, Thailand. Asian Pacific Journal of Cancer Prevention, 20(6), Article 1797. https://doi.org/10.31557/APJCP.2019.20.6.1797
Pongnasuwan, W., & Chantharakhit, C. (2023). Survival Analysis and prognostic factors for metastatic colorectal cancer patients treated with chemotherapy. Journal of the Medical Association of Thailand, 106(1). 1-7. https://doi.org/10.35755/jmedassocthai.2023.01.13726
Tamakoshi, A., Nakamura, K., Ukawa, S., Okada, E., Hirata, M., Nagai, A., ... & BioBank Japan Cooperative Hospital Group. (2017). Characteristics and prognosis of Japanese colorectal cancer patients: The BioBank Japan Project. Journal of Epidemiology, 27(3), S36-S42. https://doi.org/10.1016/j.je.2016.12.004
Tan, C., Li, Y., Wang, K., Lin, Y., Chen, Y., & Zheng, X. (2024). Causal roles and clinical utility of cardiovascular proteins in colorectal cancer risk: a multi-modal study integrating mendelian randomization, expression profiling, and survival analysis. BMC Medical Genomics, 17(1), 138. https://doi.org/10.1186/s12920-024-01909-4
Tang, M., Pearson, S. A., Simes, R. J., & Chua, B. H. (2023). Harnessing real-world evidence to advance cancer research. Current Oncology, 30(2), 1844-1859. https://doi.org/10.3390/curroncol30020143
Techawathanawanna, S., Nimmannit, A., & Akewanlop, C. (2012). Clinical characteristics and disease outcome of UICC stages I–III colorectal cancer patients at Siriraj Hospital. Journal of the Medical Association of Thailand, 95(2), S189-S198.
Tiankanon, K., Aniwan, S., & Rerknimitr, R. (2021). Current status of colorectal cancer and its public health burden in Thailand. Clinical Endoscopy, 54(4), 499-504. https://doi.org/10.5946/ce.2020.245-IDEN
Weng, M., Zhao, W., Yue, Y., Guo, M., Nan, K., Liao, Q., ... & Miao, C. (2022). High preoperative white blood cell count determines poor prognosis and is associated with an immunosuppressive microenvironment in colorectal cancer. Frontiers in Oncology, 12, Article 943423. https://doi.org/10.3389/fonc.2022.943423
Wongseree, P., Hasgul, Z., Leerapan, B., Iramaneerat, C., Phisalprapa, P., & Jalali, M. S. (2023). Dynamics of colorectal cancer screening in low and middle-income countries: A modeling analysis from Thailand. Preventive Medicine, 175, Article 107694. https://doi.org/10.1016/j.ypmed.2023.107694
Xie, H., Wei, L., Tang, S., & Gan, J. (2024). Aminotransferase-to-lymphocyte ratio as a valuable prognostic marker for patients with stage I-III colorectal cancer: a retrospective study. Frontiers in Oncology, 14, Article 1446557. https://doi.org/10.3389/fonc.2024.1446557
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