Outcome of colon cancer initially presenting as colon perforation and obstruction

World Journal of Surgical Oncology

Research

Tsung-Ming Chen¹  Guan-Chyuan Wang²  Yen-Ta Huang³ 

[1] Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan;Department of Colorectal Surgery, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung Yang Road, 970, Hualien, Taiwan;Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan;Department of Neurosurgery, Neuro-Medical Scientific Center, Buddhist Tzu Chi Hospital, 707, Section 3, Chung Yang Road, 970, Hualien, Taiwan;Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan;Surgical Intensive Care Unit, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung Yang Road, 970, Hualien, Taiwan;School of Medicine, Tzu Chi University, Hualien, Taiwan;Department of Pharmacology, Hualien, Taiwan;

关键词: Colon cancer;    Perforation;    Obstruction;   

DOI  :  10.1186/s12957-017-1228-y

 received in 2017-04-12, accepted in 2017-08-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundEmergency complications of colon cancer include perforation and obstruction which were recognized as poor prognostic factors. Few studies have directly compared the outcomes of these two groups. In this study, we evaluated mortality and morbidity in patients with colon cancer initially presenting as perforation and obstruction.MethodsNewly diagnosed colon cancer cases initially presenting with perforation or obstruction at Tzu Chi General Hospital, Hualien, Taiwan, between 2009 and 2015 were included. Cases of iatrogenic perforation or perforation sites far away from the tumor sites and rectal (< 15 cm from the anal verge) cancer were excluded. Progression-free survival, local recurrence rate, distant metastasis rate, and overall survival were the evaluated outcomes.ResultsEighty-one patients met the selection criteria; 23 and 58 patients had perforation and obstruction, respectively, as the initial symptom. The median age was 72 years. The median tumor stage was stage IIIB. The 1-year and 3-year survival rates were 83.7 and 59.7%, respectively. The perforation group (PRG) and obstruction group (OBG) did not differ significantly in intensive care unit (ICU) stay rate (p = 0.147), sex (p = 0.45), comorbidities (heart, liver, and renal diseases and diabetes mellitus), median stage (p = 0.198), and overall survival (p = 0.328). However, PRG had a higher age at diagnosis (74 vs. 64 years, p = 0.037), a higher APACHE II score (12 vs. 7, p = 0.002), lower disease-free survival (p = 0.001), a higher recurrence rate (56.5 vs. 19%, p = 0.002), a higher distant metastasis rate (39.1 vs. 13.8%, p = 0.015), and a higher local recurrence rate (43.5 vs. 5.2%, p < 0.001) than did OBG. OBG had a higher two-stage operation rate (46.6 vs. 17.4%, p = 0.022). After adjustment for the tumor stage, comorbidity (chronic renal disease), body mass index (BMI), and adjuvant chemotherapy or radiotherapy in multivariate statistics, PRG had lower disease-free survival (p = 0.005) than OBG but overall survival was identical.ConclusionFor colon cancer initially presenting as perforation or obstruction, the PRG had poorer progression-free survival, a higher local recurrence rate, and a higher distant metastasis rate than did OBG. Overall survival did not differ between these two groups.

【 授权许可】

CC BY   
© The Author(s). 2017