Analysis Of Related Cardiovascular Risk Factors For Prognosis Of Postoperative Patients With Esophageal And Colorectal Cancer

ObjectiveTo explore the influence of related cardiovascular risk factors on prognosis of postoperative patients with esophageal and colorectal cancer.MethodsClinical data of 366 patients who were diagnosised stage II to III esophageal,colon,or rectal cancer were retrospectively analyzed between January 1,2016 and December31,2016.All patients received surgical treatment with or without chemotherapy or radiotherapy.The outcome of the study included all-cause death,acute myocardial infarction,unstable angina,hospitalization for heart failure,and stroke.The time to first occurrence of endpoint was determined by telephone.Survival analysis was performed by Kaplan-Meier survival curve.Cox proportional hazards model was used to analyze the related cardiovascular risk factors affecting the prognosis.Results1.After a median follow-up of 50.4 months,a total of 115 patients developed outcomes.According to the tumor sites,the patients were divided into three groups:esophageal cancer group(n=110),colon cancer group(n=123),rectal cancer group(n=133).The incidence of endpoint events in the esophageal cancer group,colon cancer group and rectal cancer group were 38.2%,26.8%,and 30.1%,respectively.Kaplan-Meier analysis showed that the survival rate without endpoint events was no statistically significant difference among three groups(log-rank P=0.116).2.Combining colon and rectal cancer patients,the subjects were divided into two groups: esophageal cancer group(n=110)and colorectal cancer group(n=256).The incidence of endpoint events in the esophageal cancer group and colorectal cancer group were 38.2% and 28.5%,respectively.Kaplan-Meier analysis showed that the survival rate without endpoint events in patients with esophageal cancer was significantly lower than that in the colorectal cancer group(log-rank P=0.046).3.Multivariate Cox regression analysis show that,after adjustment for confounding variables,history of coronary heart disease(CHD),preoperative neutrophil to lymphocyte ratio(NLR),body mass index(BMI),serum albumin(ALB)and TNM stage were related influencing factors for endpoint events in esophageal cancer and colorectal cancer patients(CHD:HR: 2.622,95%CI: 1.570-4.377,P<0.001;NLR: HR:1.166,95%CI: 1.054-1.291,P=0.003;BMI: HR: 0.939,95%CI: 0.886-0.995,P=0.034;ALB: HR: 0.950,95%CI: 0.904-0.999,P=0.044;TNM stage: HR: 1.669,95%CI:1.129-2.469,P=0.010).4.According to the multivariate Cox regression analysis,NLR,and radiotherapy were influencing factors for endpoint events in postoperative patients with esophageal cancer(NLR: HR: 1.392,95%CI: 1.166-1.661,P<0.001;radiotherapy: HR: 0.380,95%CI: 0.167-0.863,P=0.021).5.Multivariate analysis showed that NLR was an influencing factor for endpoint events in postoperative patients with colon cancer(HR: 1.171,95%CI: 1.024-1.340,P=0.021).6.Multivariate analysis showed that hemoglobin had a statistically significant effect on endpoint events in postoperative patients with rectal cancer(HR: 0.982,95%CI: 0.965-0.999,P=0.035).7.Cox multivariate analysis found that the history of CHD and TNM stage were associated with endpoint events in colorectal cancer patients(CHD: HR: 2.744,95%CI:1.473-5.114,P=0.001;TNM stage: HR: 1.852,95%CI: 1.116-3.074,P=0.017).Conclusion:1.BMI,NLR and previous history of CHD were associated with endpoint events in esophageal cancer and colorectal cancer patients.2.High levels of NLR increased the risk of endpoint events in postoperative patients with esophageal cancer.Previous history of CHD increased the risk of endpoint events in postoperative patients with colorectal cancer.