Background: Survival outcomes in colon cancer patients undergoing curative resection are influenced not only by tumor characteristics but also by patients’ functional status and comorbidities. Understanding these associations can aid in preoperative risk stratification and postoperative management.

Methods: A cross-sectional study was conducted involving 400 patients who underwent curative resection for colon cancer across multiple hospitals in different countries. Functional status was assessed using the Eastern Cooperative Oncology Group (ECOG) scale, while comorbidities were evaluated using the Charlson Comorbidity Index (CCI). Data on demographic, clinical, and survival-related outcomes (overall survival [OS], disease-free survival [DFS]) were collected through structured questionnaires and medical records. Statistical analyses included one-way ANOVA, Pearson correlation, and multiple linear regression to assess the impact of functional status and comorbidities on survival outcomes. Significance was set at p < 0.05.

Results: The cohort had a mean age of 62.4 ± 10.7 years, with 55% male and 45% female participants. Higher ECOG scores were significantly associated with lower OS (r = -0.42, p < 0.001) and DFS (r = -0.35, p < 0.001). Patients with higher CCI scores demonstrated poorer survival outcomes (OS: r = -0.39, p < 0.001; DFS: r = -0.31, p < 0.001). ANOVA revealed significant differences in OS and DFS across functional status categories (F = 12.8, p < 0.001) and comorbidity burden groups (F = 9.6, p < 0.001). Multiple regression analysis indicated that both ECOG score (β = -0.34, p < 0.001) and CCI score (β = -0.28, p = 0.002) were independent predictors of survival outcomes after adjusting for age, sex, and tumor stage.

Conclusion: Functional status and comorbidity burden are significant independent predictors of survival in patients undergoing curative colon cancer resection. These findings highlight the importance of comprehensive preoperative assessment to guide individualized patient management and improve postoperative outcomes.