Estimating the cure proportion of colorectal cancer and related factors after surgery in patients using parametric cure models

Neda Izadi; Fatemeh Koohi; Mahdi Safarpour; Parisa Naseri; Salar Rahimi; Soheila Khodakarim

Estimating the cure proportion of colorectal cancer and related factors after surgery in patients using parametric cure models

Gastroenterol Hepatol Bed Bench. 2020 Spring;13(2):125-132.

Authors

Neda Izadi¹, Fatemeh Koohi², Mahdi Safarpour³, Parisa Naseri⁴, Salar Rahimi⁵, Soheila Khodakarim⁶

Affiliations

¹ Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Colorectal Research Center, Shiraz University of Medical Sciences, Fars, Iran.
⁶ Department of Epidemiology, School of Public Health and Safety, School of Paramedical Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

PMID: 32308933
PMCID: PMC7149811

Abstract

Aim: This study aimed to estimate the cure proportion and effects of related factors on colorectal cancer in Iranian patients after surgery.

Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer death. The relative survival of CRC varies worldwide given the quality of care, including surgical techniques.

Methods: This retrospective cohort study was conducted on 490 patients, aged 20-94 years, with colorectal cancer. All the colorectal cancer patients undergoing surgery in Faghihi hospital, Shiraz University of Medical Sciences were prospectively followed-up for 8 years from 2008 to March 8, 2016. We used parametric cure model (mixture and non-mixture) to estimate the cure proportion and the adjusted hazard ration (HR) for colorectal cancer mortality after surgery. Data were analyzed by the "flexsurvcure" package in R software (version 3.4.2).

Results: The median age of patients was 57.5 (interquartile range =18) years. Specifically, 56.33% of the patients were male. The median time of follow-up in patients was 618 days. The cumulative survival proportion varied from 0.90 to 0.49 which indicated a reduction followed by a flat line in the probability of survival by sex. The flexible survival for adjusted cure proportion (%) was 68.3. Only obesity was associated with a decreased risk of mortality (HR=0.34; 95% CI: 0.12-0.97).

Conclusion: The overall eight-year survival proportion and adjusted cure proportion for CRC were 49% and 68.3%, respectively. Knowing the cure proportion and its related factors in patients with CRC, better services can be provided. Thus, early detection and screening strategies are required to reduce mortality and increase survival of patients.

Keywords: Colorectal cancer; Cure proportion; Parametric cure model; Related factors.