title: Long-term outcome following curative surgery for malignant large bowel obstruction.
abstract: This study determined whether the long-term outcome of patients with obstructing colorectal cancer could be related to conventional pathological prognostic variables or to other clinical, operative or histological features. Ninety-eight patients with bowel obstruction who had undergone potentially curative surgery and survived the postoperative period were studied. Features related to poor long-term outcome after a median follow-up of 5 years included bowel perforation at initial operation (P = 0.007), advanced tumour stage (P < 0.001), poor tumour differentiation (P = 0.02), mucin production by tumour (P = 0.004) and the presence of vascular (P = 0.08) and neural (P = 0.004) invasion. Outcome was not significantly related to the seniority of the operating surgeon (P = 0.52), even when this was adjusted for potentially confounding variables (adjusted hazard rate ratio for trainee surgeons 1.4 (95 per cent confidence interval 0.9-2.4), P = 0.16). Conventional prognostic features may help to identify the majority of patients with obstructed colorectal cancer at high risk of tumour recurrence and death.
authors.affiliation: Gastroenterology and Liver Unit, St Vincent's Hospital, Dublin, Ireland.
authors.forename: H E
authors.initials: HE
authors.lastname: Mulcahy
authors.forename: M M
authors.initials: MM
authors.lastname: Skelly
authors.forename: A
authors.initials: A
authors.lastname: Husain
authors.forename: D P
authors.initials: DP
authors.lastname: O'Donoghue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome