Key result
Chronic kidney disease was associated with higher 30-day mortality (4.8% vs 2.1%) and was an independent prognostic factor for noncancer death (HR 1.82; 95% CI 1.07-3.10; P=0.027).
Why the study?
Does chronic kidney disease increase the risk of postoperative complications and mortality in patients undergoing elective curative resection for nonmetastatic colorectal cancer?
Cohort (n=708)
Does chronic kidney disease increase the risk of postoperative complications and mortality in patients undergoing elective curative resection for nonmetastatic colorectal cancer?
Hazard Ratio: 1.82 (95% CI 1.07–3.1)
p-value: p=0.027
In patients undergoing elective resection for nonmetastatic colorectal cancer, pre-existing CKD is associated with increased cardiovascular morbidity and is an independent predictor of noncancer death.
CKD signals higher perioperative mortality after colorectal resection; leaves open whether targeted interventions improve noncancer survival.
AIM: Chronic kidney disease (CKD) is increasing in prevalence and is associated with cardiovascular events and mortality in asymptomatic and vascular surgery populations. This study aimed to determine the role of CKD in stratifying peri- and postoperative risk for colorectal cancer (CRC) patients with nonmetastatic disease undergoing elective curative resection. METHOD: Patients diagnosed with nonmetastatic colorectal adenocarcinoma and undergoing surgical resection between 2006 and 2011 were identified from a prospectively collated database. Further information on survival and cause of death was gathered from a regional cancer registry. Estimated glomerular filtration rates were calculated using the Modification of Diet in Renal Disease (MDRD) equation. Kaplan-Meier survival curves were constructed for disease-free and overall survival. Multivariate Cox regression models were used to determine the role of CKD after stratification by several clinicopathological factors. RESULTS: Seven-hundred and eight colorectal resections were studied [median follow up: 45 (interquartile range, 21-65) months). Overall postoperative complications were similar, but patients with CKD were more likely to develop cardiovascular morbidity (P < 0.001) and 30-day mortality [4.8% (six of 124) in the CKD group vs 2.1% (12/580) in the non-CKD group]. Kaplan-Meier analysis revealed poorer overall survival for localized (Stage I-II; P = 0.019) and Stage III (P = 0.001) CRC in the CKD population. Multivariate Cox regression analysis identified CKD as an independent prognostic factor for noncancer death [hazard ratio (HR) = 1.82 (95% CI: 1.07-3.10); P = 0.027] but not for overall survival [HR = 1.21 (95% CI: 0.90-1.47); P = 0.116]. CONCLUSION: Patients with CKD may be more likely to develop cardiovascular complications following CRC resection and have an increased risk of a noncancer death. Future research should explore the interaction of CKD in competing mortality risks following CRC surgery.
No takes yet. Share an insight, caveat, or question.
Currie et al. (2014) conducted a cohort in Nonmetastatic colorectal adenocarcinoma (n=708). Chronic kidney disease (CKD) vs. Non-CKD was evaluated on Noncancer death (HR 1.82, 95% CI 1.07-3.10, p=0.027). Chronic kidney disease was associated with higher 30-day mortality (4.8% vs 2.1%) and was an independent prognostic factor for noncancer death (HR 1.82; 95% CI 1.07-3.10; P=0.027).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: