Developing a Simple Conceptual Model for Predicting Early Recurrence and Mortality after Curative Surgery for Colorectal Cancer Patients

Abstract

Abstract Introduction: A generalized structural equation model with accelerated failure time for survival analysis in predicting early recurrence and mortality following curative surgery in colorectal cancer patients. Methods: This retrospective cohort study included 284 patients with colorectal cancer who underwent surgery at Imam Khomeini Clinic in Hamadan between 2001 and 2017. Demographic and other relevant data were extracted from patient records, including age at diagnosis, sex, clinical and pathological variables, first treatment type and date, tumor differentiation degree, disease stage, and treatment types (surgery, chemotherapy, and radiotherapy). Predictors were included in a generalized structural equation model for survival analysis with an accelerated failure time (AFT) model, and both unadjusted and adjusted time ratios (TRs) were calculated. Results: The study findings indicate that patients who did not receive chemotherapy had a lower survival time ratio [TR=0.443, 0.307 - 0.637], and those who underwent multiple chemotherapy sessions had an increased survival time [TR=2.007, 1.690 - 2.383]. Female patients had longer survival times than male patients [TR=1.137, 0.981- 1.318]. Additionally, disease progression to higher stages was associated with a decrease in survival times [TR=0.433, 0.348- 0.539]. Conclusion: According to the optimal model, age, number of chemotherapy sessions, and disease stage were found to have a significant relationship. Therefore, regular screening and preventive measures are recommended for target groups to help identify and manage colorectal cancer early and potentially improve patient outcomes.