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Erschienen in: World Journal of Surgery 5/2010

01.05.2010

The Effect of Obstruction and Perforation on Colorectal Cancer Disease-Free Survival

verfasst von: Yik-Hong Ho, Simon K. K. Siu, Petra Buttner, Andrew Stevenson, John Lumley, Russel Stitz

Erschienen in: World Journal of Surgery | Ausgabe 5/2010

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Abstract

Background

Obstruction (OBSTR) and perforation (PERF) in colorectal cancer impact adversely upon outcomes, and cancer-related survival may also be affected. However, data are sparse, particularly on disease-free survival (DFS) where the cancer is both obstructed and perforated (OBS-PERF).

Methods

Data were extracted from a prospectively collected database of 1876 colorectal cancer patients managed and followed up at the Royal Brisbane Hospital from 1984 to 2004. The patients who had curative surgery (n = 1426) were classified as OBSTR (n = 153), PERF (n = 53), OBS-PERF (n = 19), and uncomplicated (UNCOM; n = 1201). Kaplan-Meier survival and Cox proportional hazard analyses were performed.

Results

Postoperative mortality within 30 days of surgery was 1.5% (n = 22) and the overall complication rate was 40.8% (n = 582). However, only 7.2% (n = 102) required reoperations. The median survival time was 71 (IQR = 64.9–77.1) months and the median follow-up for DFS was 37.5 (IQR 14–68) months. The overall recurrence rate was 32.7% (n = 466), the local recurrence rate was 9.4% (n = 135), and local and distant recurrences occurred in the same patient in 4.7% (n = 67). Male gender, OBSTR, PERF, OBS-PERF, emergency operation, major medical and surgical complications, reoperation, TNM staging, tumor grading, and tumor venous invasion adversely affected DFS (p < 0.05). Multivariate analysis showed that OBS-PERF (p = 0.008), major medical complications (p = 0.011), reoperation (p = 0.018), TNM staging (p < 0.001), grading (p = 0.018), and venous invasion (p = 0.002) were independently associated with a poorer DFS.

Conclusions

OBS-PERF colorectal cancer is associated with a poorer DFS, which may be worse than either OBSTR or PERF alone.
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Metadaten
Titel
The Effect of Obstruction and Perforation on Colorectal Cancer Disease-Free Survival
verfasst von
Yik-Hong Ho
Simon K. K. Siu
Petra Buttner
Andrew Stevenson
John Lumley
Russel Stitz
Publikationsdatum
01.05.2010
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 5/2010
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-010-0443-2

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