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Acta Médica Costarricense

On-line version ISSN 0001-6002Print version ISSN 0001-6012


RAMOS-ESQUIVEL, Allan; GARITA-ROJAS, Esteban  and  MASIS-MARROQUIN, Adriana. Determinants of survival in a cohort of Costa Rican patients with colorectal cancer. Acta méd. costarric [online]. 2022, vol.64, n.2, pp.16-23.  Epub June 01, 2022. ISSN 0001-6002.


To identify prognostic variables of overall survival in a cohort of Costa Rican patients with colorectal adenocarcinoma who were treated at the San Juan de Dios Hospital between January 2010 and December 2015.


A retrospective cohort study was conducted with all patients diagnosed with colorectal adenocarcinoma during the study period. Clinical variables were obtained from medical records. Determinants of overall survival were identified by a Cox univariate and multivariate regression analysis, with its respective hazard ratio (HR) and 95% confidence interval (IC 95%).


A total of 667 patients were included in this study. Median follow-up was 25.4 months. Five-year survival according to clinical stage was 91.7%, 60%, 44.9% and 18.9% for stages I, II, III, and IV, respectively. In the univariate analysis, age greater than 65 years, tumor grade, dvanced clinical stage, poor performance status, proximal location of the primary tumor, a high index of positive nodes and negative retrieved nodes, and the absence of microsatelital instability were statistically associated to death.

However, after adjustment for potential confounders, only the performance status at the beginning of treatment (HR: 3.06; IC 95%: 1.65-5.69; p<0.001 for the comparison of ECOG 0 vs 1 and 2.) and age older than 65 years (HR: 1.64, IC 95%: 1.10-2.43; p=0.014) were independently associated with overall survival.


Functional status at the time of diagnosis and clinical stage were the independent variables associated to survival in the studied cohort.

Keywords : Colonic neoplasms; Costa Rica; mortality; prognosis; survival.

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