Prognostic influence of clinicopathological and laboratory factors on colorectal cancer survival in Amhara region oncology centers, retrospective cohort study, Ethiopia, 2024

Abstract

Colorectal cancer (CRC), originating in the colon or rectum, is a leading cause of mortality worldwide. Patient survival is influenced by multiple factors, including access to healthcare, early diagnosis, and treatment. This study evaluates the prognostic influence of clinicopathological and laboratory factors on colorectal cancer survival. A cohort study was conducted at an institutional level retrospective cohort, including 464 participants who began follow-up between July 1, 2018, and June 30, 2023. Data were entered into Epidata V4.2 and analyzed using STATA V14. Cox regression models were applied to identify factors associated with mortality. Variables with a P-value < 0.25 in the bivariable analysis were included in the multivariable Cox regression model, with statistical significance set at P ≤ 0.05. Several factors significantly impacted survival, including rectal cancer (AHR = 1.88, 95% CI: 1.27–2.78), colorectal cancer (AHR = 2.29, 95% CI: 1.56–3.36), baseline ALP levels ≥ 127 IU/L (AHR = 1.56, 95% CI: 1.15–2.09), poor WHO/ECOG performance status (AHR = 2.41, 95% CI: 1.74–3.34), and late-stage cancer (AHR = 3.46, 95% CI: 2.14–5.59). Key determinants of CRC survival include ALP levels, tumor stage, performance status, and tumor location. Enhancing diagnostic capabilities and ensuring continuous patient monitoring may improve outcomes.