The Relationship between the Presentation of Hematochezia and Colon Cancer

Abstract

Objective. Hematochezia is one of the most common symptoms of colon cancer. This study investigated whether the presence of hematochezia could indicate additional clinical information on non-metastatic colon cancer.Methods. In this retrospective study, we enrolled 3641 consecutive nonmetastatic colon cancer patients. Logistic regression analysis was performed to determine the correlation between hematochezia and other characteristics and postoperative outcome of colon cancer. The Cox regression model was used to determine the correlation between hematochezia and long-term survival in colon cancer patients.Results. Logistic regression analysis showed that hematochezia was significantly associated with tumor location (left vs. right: odds ratio [OR]=3.19; p＜0.001), tumor morphology (polypoid vs. non-polypoid: OR=1.33; p=0.005), and circumferential involvement (no vs. yes: OR=1.48;p＜0.001). Compared to patients with hematochezia, those without hematochezia were more likely to have hypoalbuminemia (20.4% vs. 14.5%; p＜0.001), obvious anemia (27.0% vs. 23.6%; p=0.020), and abnormal carcinoembryonic antigen levels (37.1% vs. 33.6%; p=0.028). Postoperative morbidity and mortality were not significantly correlated with hematochezia. The 5-year overall survival rates of patients with and without hematochezia were 77.9% and 73.0%, respectively (p＜0.004), and the 5-year relapse-free survival rates were 74.7% and 70.4%, respectively (p=0.015). However, multivariate analysis showed that hematochezia was not a significant prognostic factor of overall survival and relapse-free survival. Conclusion. Hematochezia in colon cancer patients is not only an alert symptom, but is also correlated with tumor location, tumor morphology, and circumferential involvement. However, it is not a prognostic factor for poor long-term outcome in non-metastatic colon cancer patients.