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Showing content from https://pubmed.ncbi.nlm.nih.gov/31709491/ below:

Oncologic long-term outcomes of emergency versus elective resection for colorectal cancer

Observational Study

. 2019 Dec;34(12):2091-2099. doi: 10.1007/s00384-019-03426-8. Epub 2019 Nov 11. Oncologic long-term outcomes of emergency versus elective resection for colorectal cancer

Affiliations

¹ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
² Institute of Pathology, University of Bern, Bern, Switzerland.
³ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. beat.schnueriger@insel.ch.

PMID: 31709491
DOI: 10.1007/s00384-019-03426-8

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Observational Study

Oncologic long-term outcomes of emergency versus elective resection for colorectal cancer

Joël L Lavanchy et al. Int J Colorectal Dis. 2019 Dec.

Free article . 2019 Dec;34(12):2091-2099. doi: 10.1007/s00384-019-03426-8. Epub 2019 Nov 11. Affiliations

¹ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
² Institute of Pathology, University of Bern, Bern, Switzerland.
³ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. beat.schnueriger@insel.ch.

PMID: 31709491
DOI: 10.1007/s00384-019-03426-8

Item in Clipboard

Abstract

Purpose: Long-term outcomes in patients undergoing emergency versus elective resection for colorectal cancer (CRC) are discussed controversially. This study aims to assess long-term outcomes of emergency versus elective CRC surgery.

Methods: Single-center retrospective cohort study. Patients undergoing emergency or elective CRC surgery from July 2002 to January 2013 were included. Primary outcome was 5-year survival, secondary outcomes were in-hospital mortality and local tumor recurrence.

Results: Overall, 475 patients were included. Median age was 69.0 (IQR 59.0-77.0) years. A total of 141 patients (30%) were operated for rectal cancer and 334 patients (70%) for colon cancer. Median follow-up was 445 (IQR 67-1409) days. Emergency resection was performed in 105 patients (22%) due to obstruction, perforation, or bleeding. Stage IV tumors and ASA scores≥ 3 were significantly more frequent in the emergency than in the elective resection group (39.0% vs. 33.5%, p < 0.001; 75.5% vs. 61.3%, p = 0.003). The rate of patients with positive lymph nodes was similar in the two groups (46.2% vs. 46.3%, p = 1.000). In-hospital mortality was significantly higher in the emergency CRC versus the elective CRC group (8.4% vs. 3.0%, p = 0.023). Five-year survival (aHR 1.38; 95%CI 0.81-2.37, p = 0.237) or local tumor recurrence (aHR 1.48; 95%CI 0.47-4.66, p = 0.500) were not significantly different in patients undergoing emergency versus elective surgery for CRC.

Conclusion: In-hospital mortality was increased in emergency versus elective CRC resections. However, 5-year survival and local recurrence after surgery for CRC were determined by the tumor stage, and not by the emergency versus elective setting of surgical resection.

Keywords: Colorectal cancer; Elective colorectal cancer resection; Emergency colorectal cancer resection; Five-year survival; Recurrence-free survival.

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