Analysis of comorbidities in patients with locally advanced colon cancer

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Colon cancer is one of the five most common cancers worldwide and is more common in elderly patients who, in addition to the primary cancer, often have a number of other concomitant diseases. Objective. Detailed analysis of the structure of concomitant diseases in patients with locally advanced colon cancer. Material and methods. A prospective study involving 254 patients with locally advanced colon cancer (cT4N0M0, cT1-4N1-2M0) was conducted at the Botkin Hospital. Statistical analysis of the data was performed using RStudio software (version 4.3.3). A phenotypic disease network (PDN) was constructed with the calculation of the cosine index value for all possible pairs of comorbidities. Results. Concomitant diseases were detected in 96.5% of patients. The most common diseases were arterial hypertension (68.9%), obesity (61.0%), anemia (50.0%), gastritis, gastric ulcer and duodenal ulcer (32.3%), and coronary heart disease (30.3%). Women had a greater number of concomitant diseases compared to men (median 4.0 and 3.0, respectively, p=0.009). Women more often had hypertension (74.2%), gastrointestinal diseases (39.5%) and thyroid gland diseases (19.7%), while men had COPD (5.6%). A total of 112 pairs of concomitant diseases were obtained. The minimum cosine index value was 0.047 for the pair CKD + cardiomyopathy, the maximum was 0.697 for the pair hypertension + obesity. Five pairs of comorbidities with a cosine index value of more than 0.5 were identified: hypertension + obesity (cosine index 0.697), hypertension + anemia (cosine index 0.618), hypertension + coronary heart disease (cosine index 0.593), anemia + obesity (cosine index 0.555), hypertension + gastric ulcer and duodenal ulcer, gastritis (cosine index 0.507). Conclusion. Most patients with colon cancer have a number of concomitant diseases that coexist in various combinations. Their correction in specialized departments will allow choosing the most optimal treatment option taking into account a personalized approach, which, in the future, can improve the prognosis of comorbid patients with locally advanced colon cancer.

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