Factors contributing to survival in hepatic dysfunction due to colorectal cancer

Abstract

Introduction/Objective Colorectal cancer (CRC) is currently the third most common cancer in incidence in the United States and accounts for about 8.5% of all cancer related deaths. Our study aim was to determine the parameters that contribute to the survival of CRC patients with hepatic dysfunction, attention to the positive effects on survival when the most appropriate clinical approaches.

Methods Patients with CRC, diagnosed with hepatic dysfunction, and who were followed up in our inpatient service in the last two years were included in our study. Survival rates were analyzed starting from after the development of hepatic failure.

Results A total of 57 patients were included in the study, 44 (77.2%) were colon carcinoma, and 13 (22.8%) were rectal carcinoma patients, and 14 (24.56%) were female. Bile duct dilatation (BD) was detected in 19 (33%) of 57 patients with imaging methods. The median OS was calculated as 4 vs. 1.4 months in patients with BD compared to patients without BD (p < 0.001). Survival times were significantly higher in patients with BD compared to those without dilatation, and in patients without renal failure compared to those with renal failure.

Conclusion In cancer patients with hepatic dysfunction, those with additional renal failure had shorter survival times and a worse prognosis. The longer survival of patients with BD was attributed to the optimal timing of the percutaneous transhepatic cholangiography insertion, close clinical and inflammation marker follow-ups, and early prevention of external biliary drainage, therefore preventing a possible septic complication early on.

Keywords: colorectal cancer; hepatic dysfunction; percutaneous transhepatic biliary drainage; survivability