Atrial fibrillation and survival in colorectal cancer

A prospective colorectal cancer patient database was cross-referenced with the hospital clinical-coding database to identify patients who had underwent colorectal cancer surgery and were in atrial fibrillation pre- or postoperatively.A total of 175 patients underwent surgery for colorectal cancer over a two-year period. Of these, 13 patients had atrial fibrillation pre- or postoperatively. Atrial fibrillation correlated with worse two-year survival (p = 0.04; log-rank test). However, in a Cox regression analysis, atrial fibrillation was not significantly associated with survival.The presence or development of atrial fibrillation in patients undergoing surgery for colorectal cancer is associated with worse overall survival, however it was not found to be an independent factor in multivariate analysis.In general, colorectal cancer patients are three times more likely to be in atrial fibrillation preoperatively than matched controls undergoing non-colorectal cancer surgery [1,2]. It may also occur postoperatively. Recent data suggest that atrial fibrillation may be an inflammatory complication, resulting from the initiation of an inflammatory response to surgery or infection [3-6]. Colorectal cancer patients may have elevated C-reactive protein (CRP) levels [7] indicating a systemic inflammatory response. Elevated CRP levels may be associated with a worse prognosis in colorectal cancer patients [8]. Postoperative dysrhythmias may [9] or may not [10] be associated with worse survival following surgery for lung cancer. We hypothesised that atrial fibrillation (AF) is an adverse prognostic indicator in patients undergoing surgery for colorectal cancer.Patients who underwent a resection for colorectal cancer between 1st January 2000 and 31st December 2001 in a 600-bed district general hospital in the United Kingdom National Health Service were identified. The hospital serves a population of approximately 230,000. About 90 elective and emergency laparotomies are performed e