Diaz-Cordova M, Sharma I, Okumura K. Letter to the Editor: Toward better mortality prediction in intensive care unit-admitted colorectal cancer patients. World J Gastrointest Oncol 2026; 18(4): 114373 [DOI: 10.4251/wjgo.v18.i4.114373]
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Kenji Okumura, MD, Associate Faculty, Department of Surgery, Westchester Medical Center and New York Medical College, 100 Woods Road, Valhalla, NY 10595, United States. kenji.okumura@wmchealth.org
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Apr 15, 2026 (publication date) through Apr 11, 2026
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World Journal of Gastrointestinal Oncology
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Diaz-Cordova M, Sharma I, Okumura K. Letter to the Editor: Toward better mortality prediction in intensive care unit-admitted colorectal cancer patients. World J Gastrointest Oncol 2026; 18(4): 114373 [DOI: 10.4251/wjgo.v18.i4.114373]
World J Gastrointest Oncol. Apr 15, 2026; 18(4): 114373 Published online Apr 15, 2026. doi: 10.4251/wjgo.v18.i4.114373
Letter to the Editor: Toward better mortality prediction in intensive care unit-admitted colorectal cancer patients
Marco Diaz-Cordova, Ishani Sharma, Kenji Okumura
Marco Diaz-Cordova, Ishani Sharma, Kenji Okumura, Department of Surgery, Westchester Medical Center and New York Medical College, Valhalla, NY 10595, United States
Author contributions: Diaz-Cordova M and Sharma I contributed with writing, editing and literature review; Okumura K provided writing, senior editing, and final revisions of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Kenji Okumura, MD, Associate Faculty, Department of Surgery, Westchester Medical Center and New York Medical College, 100 Woods Road, Valhalla, NY 10595, United States. kenji.okumura@wmchealth.org
Received: September 17, 2025 Revised: November 26, 2025 Accepted: January 6, 2026 Published online: April 15, 2026 Processing time: 203 Days and 8.4 Hours
Abstract
Colorectal cancer (CRC) remains a leading cause of cancer death worldwide. Dong et al evaluated prognostic factors associated with short-term outcomes among intensive care unit (ICU)-admitted CRC patients and highlighted the lack of a reliable prognostic tool despite commonly used ICU scores such as Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II. Their multicenter cohort (n = 189) reported a 90-day ICU mortality of 12.2%; however, modest sample size limits generalizability. The study by Dong et al, published in the recent issue of the World Journal of Gastrointestinal Oncology, links higher Sequential Organ Failure Assessment scores and emergency surgery to increased 90-day mortality in stage III disease. We argue that a robust prognostic model for this population should be multidimensional – incorporating frailty, cancer stage and treatment context (elective vs emergency surgery), comorbidities, nutritional and socioeconomic status, and timing/acuity of ICU transfer. Prospective, adequately powered studies are needed to develop and validate such tools to guide ICU triage and optimize outcomes for CRC patients. This manuscript call attention to the urgent need for validated, multidimensional prognostic models to guide ICU decision-making in CRC care.
Core Tip: Colorectal cancer remains a leading cause of cancer-related mortality globally. While screening and treatment have increased disease prevalence, reliable predictors of 90-day mortality in intensive care unit-colorectal cancer treated patients are lacking. Prognostic scores such as Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment show potential but require further validation. Additionally, factors like frailty, cancer stage, socioeconomic status, and surgical urgency may influence outcomes/prognosis. Currently, no single tool adequately captures the complexity of prognosis in this population, highlighting the need for prospective studies to develop a more comprehensive and accurate prognostic model.
