ArticleCureus2025
Impact of Comorbidities on Treatment Outcomes Among Saudi Patients With Colorectal Cancer: A Retrospective Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of intravenous ferric carboxymaltose versus oral iron in pregnant women with anemia: a systematic review and meta-analysis.European journal of clinical pharmacology · 2026Pooled it
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10 authors.
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Abstract
backgroundColorectal cancer is a leading cause of cancer-related morbidity and mortality worldwide and is among the most common malignancies in Saudi Arabia. The high prevalence of chronic noncommunicable diseases in the Saudi population raises concern regarding the impact of comorbidities on colorectal cancer outcomes. However, local data evaluating the prognostic significance of comorbidity burden remain limited.
methodsWe conducted a retrospective cohort study across government health cluster hospitals in Saudi Arabia. Adult patients with histologically confirmed colorectal cancer diagnosed between January 2015 and December 2022 were included. Demographic, clinical, tumor-related, and treatment data were extracted from electronic medical records. Comorbidity burden was assessed using the Charlson Comorbidity Index (CCI). Patients were stratified by comorbidity status and CCI score (<3 vs. ≥3). The primary outcome was overall survival; secondary outcomes included disease-free survival, cancer-related mortality, postoperative complications, and treatment completion. Survival analyses were performed using Kaplan-Meier methods and Cox proportional-hazards models.
resultsA total of 312 patients were included (mean age: 61.8±11.9 years; 59.9% male). At least one comorbidity was present in 214 patients (68.6%), and 74 patients (23.7%) had a CCI score of 3 or higher. Hypertension (47.1%) and diabetes mellitus (42.3%) were the most common comorbidities. Advanced disease (stage III-IV) was observed in 215 patients (68.9%). Patients with higher comorbidity burden were less likely to undergo curative-intent surgery (60.8% vs. 83.2%) or complete adjuvant chemotherapy (35.1% vs. 62.6%) and experienced higher rates of postoperative complications (37.8% vs. 16.4%). Five-year overall survival was significantly lower among patients with comorbidities than those without comorbidities (48.2% vs. 66.7%, p=0.002), and disease-free survival was similarly reduced (42.6% vs. 59.1%, p=0.01).
conclusionsComorbidities are highly prevalent among Saudi patients with colorectal cancer and are associated with reduced treatment delivery and significantly poorer survival outcomes. Systematic assessment and proactive management of comorbidity burden should be integrated into colorectal cancer care to improve prognosis and optimize treatment outcomes.
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