Clinical presentation predicts the outcome of patients with colon cancer

Table 1 Estimates and scores used for creation of the clinical score

Symptom	Odds ratio	Points
Pain	1.2	1
Diarrhea	1.2	1
Constipation	0.91	-1
Vomiting	1.3	2
Weight loss	1.1	1
Rectal bleeding	0.65	-3
Melena	2.5	5
Change in BH	1.1	1
Legend
	0.5-0.7	-3
	0.7-0.9	-2
	0.9-1.0	-1
	1.0-1.2	1
	1.2-1.4	2
	1.4-1.6	3
	1.6-1.8	4
	>1.8	5

BH: Bowel habits.

Table 2 Distribution of symptoms among patients, divided according to the Union for International Cancer Control TNM staging system n (%)

Stage	Abdominal pain	Diarrhea	Constipation	Vomit	Weight loss	Rectal bleeding	Melena	Change in BH1
1	10 (30.3)	3 (9.0)	11 (33.3)	1 (3.0)	11 (33.3)	8 (24.2)	1 (3.0)	11 (33.3)
2a	44 (62.8)	11 (15.7)	20 (28.6)	11 (15.7)	22 (31.4)	11 (15.7)	2 (2.8)	34 (48.6)
2b	2 (66.6)	0 (0.0)	0 (0.0)	1 (33.3)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
3a	5 (45.4)	1 (9.0)	2 (18.2)	1 (9.0)	3 (27.3)	0 (0.0)	0 (0.0)	1 (9.0)
3b	15 (44.1)	3 (8.8)	8 (23.5)	3 (2.9)	6 (17.6)	5 (14.7)	1 (2.9)	10 (29.4)
3c	10 (37.0)	1 (3.7)	10 (37.0)	3 (11.1)	7 (25.9)	10 (37)	0 (0.0)	15 (55.5)
4	35 (60.3)	7 (12.1)	18 (31.3)	7 (12.1)	28 (48.3)	13 (22.4)	3 (5.2)	27 (46.5)
Total	121 (51.3)	26 (11)	69 (29.2)	27 (11.4)	77 (32.6)	47 (19.9)	7 (2.9)	98 (41.5)
P value	0.01	0.78	0.79	0.35	0.04	0.14	0.95	0.03

¹Staging system according to the Union for International Cancer Control. BH: Bowel habits.

Table 3 Comparison of symptoms with respect to tumor location n (%)

Symptom	Left colon n = 139	Right colon n = 97	P value
Pain	73 (52.5)	48 (49.5)	0.7
Diarrhea	12 (8.6)	14 (14.4)	0.2
Constipation	47 (33.8)	22 (22.7)	0.08
Vomiting	16 (11.5)	11 (11.3)	1
Weight loss	48 (34.5)	29 (29.9)	0.48
Rectal bleeding	37 (26.6)	10 (10.3)	0.002
Melena	5 (3.6)	2 (2.1)	0.71
Change in BH	68 (48.9)	30 (30.9)	0.006

¹Fisher’s exact test. BH: Bowel habits.

Table 4 Crude univariate analysis comparing the presentation of symptoms among survivors and non-survivors n (%)

Symptom	Survivors n = 142	Non-survivors n = 93	Univariate P value	Multivariate P value	OR (95%CI)
Pain	66 (46.2)	55 (59.1)	0.05	0.38	1.4 (0.7-2.8)
Diarrhea	13 (9.1)	13 (14)	0.24	0.51	1.5 (0.4-5.6)
Constipation	41 (28.7)	28 (30.1)	0.81	0.91	0.94 (0.3-2.7)
Vomiting	12 (8.4)	15 (16.1)	0.07	0.24	1.9 (0.6-5.6)
Weight loss	43 (30)	34 (36.6)	0.32	0.63	0.8 (0.4-1.7)
Rectal bleeding	34 (23.8)	13 (14)	0.06	0.004	0.25 (0.1-0.7)
Melena	2 (1.4)	5 (5.4)	0.1	0.04	7.4 (1.1-72.7)
Change in BH	56 (39.2)	42 (45.2)	0.36	0.96	1 (0.4-2.9)

A stepwise logistic regression model utilizing a likelihood ratio test was applied controlling for, age, stage and the duration of complaints. BH: Bowel habits.

Table 5 Clinical score predicts mortality independently of age, stage and the duration of complaints

	Mortality	OR (95%CI)
Clinical score > 1	0.001	3.1 (1.5-6.1)
Age	0.003	0.96 (0.94-0.99)
Stage	< 0.001	35 (5.3-703.7)
Duration of complaints	0.05	0.6 (0.26-1.0)

Stepwise logistic regression analysis with the application of a likelihood ratio test. OR: Odds ratio.