Abstract
This study evaluated the natural history of advanced colon cancer and determined prognosis after discontinuation of chemotherapy and introduction of palliative care for such patients. We also sought to determine if there are prognostic factors that predict survival in advanced colon cancer. A prospective enrollment of patients with a diagnosis of metastatic colon cancer into a database captured data on over 500 colon cancer patients who had undergone at least two episodes of treatment with chemotherapy, radiation therapy or secondary surgery for their condition. They were followed until death and an average length of survival was determined. The quartiles of survival were calculated and clinical and laboratory criteria were compared to see if prognostic factors could be identified that predicted the quartile of survival. The mean survival for patients with advanced colon cancer after discontinuation of either chemotherapy or radiation therapy was months. Several predictors of the poorest prognosis were identified, including small bowel obstruction, significant ascites requiring repeat paracentesis, bilirubin elevation, creatinine elevation, and hepatic encephalopathy. Prognosis of patients with colon cancer who discontinue treatments is poor. Survival can be predicted by clinical and laboratory characteristics easily identified by practitioners.
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