Oncologic outcome of colon cancer with perforation and obstruction

Abstract

Purpose: Perforation and obstruction in colorectal cancer are poor prognostic factors. We aimed to evaluate the oncological outcomes of patients with colon cancer presenting with perforation or obstruction.

Methods: A total of 260 patients underwent surgery for colon cancer between January 2015 and December 2017. Among them, 54 patients who underwent emergency surgery for perforated (n=32) or obstructive (n=22) colon cancer were included.

Results: The perforation (PG, n=32) and obstruction groups (OG, n=22) did not difer signifcantly in age (p=0.486), sex (p=0.821), tumor stage (p=0.221), tumor location (p=0.895), histologic grade (p=0.173), or 3-year overall survival rate (55.6% vs. 50.0%, p=0.784). However, the PG had a higher postoperative complication rate (44% vs. 17%, p=0.025), longer intensive care unit stay (4.8 days vs. 0.8 days, p=0.047), and lower 3-year recurrence-free survival (42.4% vs. 78.8%, p=0.025) than the OG. In the multivariate analysis, perforation was signifcantly increased risk of recurrence (hazard ratio=3.67, 95% confdence interval: 1.049–12.839, p=0.042).

Conclusion: Patients with colon cancer initially presenting with perforation had poorer recurrence-free survival, higher postoperative complication rates, and longer ICU stays than those who had obstruction.