The impact of Chronic Obstructive Pulmonary Disease on Outcome of Patients with Colorectal Cancer

Abstract

Background: Chronic obstructive pulmonary disease (COPD) could potentially elevate the risk of postoperative complications and, consequently, mortality following colorectal cancer (CRC) surgery. This topic holds significant clinical importance, yet no prior studies have been undertaken in our specific study area. Therefore, we are planning to conduct a study to address this knowledge gap. Objective: The present study was conducted to investigate the impact of COPD on final outcome of colorectal cancer and its surgery Methodology: A cross-sectional observational investigation was conducted at a subset of Rawalpindi, Pakistan's tertiary care hospitals. IBD patients with colorectal cancer, and divided the study cases on the basis of COPD presence or absence. All study cases were interviewed and their medical records reviewed in order to compile data. Results: A total of 240 patients included in this study. The average age of the cohort was 42.13+11.9 years. The average age of CRC patients was 45.08 years, compared to 40.20 years for non-CRC patients (p<0.05). Respiratory risk factors including smoking was strongly correlated with CRC (p<0.05). Dietary patterns substantially affected the risk of CRC, with Western diet consumers having 3.2-fold greater risk than vegetarians (p<0.05). Immunosuppressant use was associated with twofold increase in incidence of CRC (p<0.05). Other factors also demonstrated significant associations, including physical activity level, hemoglobin increase, respiratory factors and C-reactive protein increase (p<0.05). Of these, 7.9% had a prior diagnosis of COPD. Among patients with COPD, 16.1% were admitted postoperatively to the intensive care unit, 1.9% were treated with mechanical ventilation, and 3.6% were treated with non-invasive ventilation. In patients without COPD, the corresponding proportions were 9.7%, 1.1% and 1.1%. The reoperation rate was 10.6% among patients with COPD and 8% among patients with cancer without COPD. 30-day mortality was 13% (95% CI 11.4% to 14.9%) among patients with COPD and 5.3% (95% CI 5.0% to 5.7%) among patients without COPD, corresponding to an adjusted HR of 1.7 (95% CI 1.5 to 2.0). Conclusion: This study has emphasized the significance of several key factors, including age, respiratory variables like smoking, a history of respiratory conditions, exposure to air pollutants, dietary habits, and specific medications. These factors significantly impact the progression from Inflammatory Bowel Disease (IBD) to Colorectal Cancer (CRC). This underscores the necessity for tailored prevention strategies and interventions for individuals with IBD who are at risk. Additionally, it is important to note that COPD serves as a robust predictor for both intensive care unit admissions and mortality following CRC surgery. Keywords: Colorectal Cancer; COPD; Dietary habits; Respiratory risk factors