Comorbidity and other predictors of survival in veterans with colorectal cancer (CRC) at different stages.

Abstract

e14625 Background: We analyzed comorbidity and other predictors of survival for patients (pts) with different stages of CRC. Methods: In an IRB-approved protocol, we reviewed the records of pts diagnosed with CRC at a VA medical center from 01/01/2003 to 12/31/2011 for demographics, stage, grade, ECOG performance status (PS), CEA, Hemoglobin (HGB), and Albumin (ALB) at diagnosis (dx). Comorbidity was assessed with the Charlson Comorbidity Index (CCI), the Cumulative Illness Rating Scales (CIRS), and the Kaplan-Feinstein Index (KFI). Statistical analyses were performed with SAS 9.2/Stata 11.0. We compared the pts with curative stage (0-III) vs late stage (IV) CRC. Results: There were 279 men. 156 pts (55.9%) were Caucasians, 106 pts (38%) African Americans, 15 pts (5.4%) Hispanics, and 2 pts (0.7%) Asians. The median (M) age at dx was 70 (45-90) years. 132 pts (47.3%) were deceased. 209 pts were curative stage at dx, 54 pts late stage and 16 pts unknown stage. Age and race were not different between the two stage groups. The late group had higher histological grades (P<0.001). In univariate analysis, age, stage, grade, ECOG PS, HGB, ALB, CCI, CIRS16, CIRS 17, CIRS 19, and KFI are significant predictors of survival for all stage pts. Significant predictors for curative stage pts are age, ECOG PS, HGB, CCI, CIRS16, CIRS17, and CIRS 18, and for late stage pts are grade, ECOG PS, ALB, and CCI. Significant factors by multivariate analysis are summarized in the table. Conclusions: These findings from this larger population confirm our earlier findings (ASCO 2012 e14125). Grade, stage, ECOG PS, and CIRS 19 (very severe comorbidity) are important independent survival predictors for veterans with CRC. Independent predictors for curative stage pts are ECOG PS and CIRS 16 (comorbidity severity summary score), and for late stage pts are ALB, CCI and CIRS 19. The late stage pts had higher grades. Further studies are needed to confirm this observation. Supported by NJCCR. [Table: see text]