The Demographic Profile of Colorectal Cancer Patients in Indonesia: Insights from a Single Center Experience and Exploration of Immune Response and Survival Outcomes

Abstract

Background Understanding the demographics, tumor characteristics, genetic mutations, and immune scores in colorectal cancer (CRC) patients may aid in tailoring treatment and predicting survival. Methods This retrospective cohort study assessed clinical parameters, immune scores, and their relationship with survival in patients with CRC. Results The study included 74 patients, mean age 53.7 years, mostly male (53.3%) and aged 41-70 (77.3%). Common comorbidities included cardiovascular diseases (29.3%) and hypertension (21.3%). Adenocarcinoma (74%) primarily affects the colon (73%). KRAS mutations and Microsatellite instability-High (MSI-H)/deficient mismatch repair (dMMR) were found in 1.3% and 16% of patients, respectively. Stage IV (77.3%) and liver metastases (52.7%) were prevalent. Immune score was influenced by cancer stage (p = 0.04) and metastasis (p=0.05). The immune score was not associated with survival (p = 0.181). Patients with comorbidities had lower one- (p = 0.027) and two-year survival rates (p = 0.037) survival rates. Cardiovascular comorbidities negatively impacted one-year survival (p = 0.047) and two-year survival (p = 0.037). The mean survival time was shorter for males (2.047±0.288 vs. 2.781±0.195 years, p = 0.041), patients with comorbidities (1.772±0.371 vs. 2.702±0.188 years, p = 0.017), and cardiovascular comorbidities (1.558±0.316 vs. 2.685±0.207 years, p = 0.038). Comorbidities (unadjusted hazard ratio [HR] 2.948, p = 0.023) and cardiovascular comorbidities (unadjusted HR 2.695, p = 0.046) were initially associated with survival but lost significance after adjusting for confounding variables. Conclusions This study provides insights into CRC patient demographics and their interplay with the immune score and survival.