Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancer.
BACKGROUND
The aim of this observational study was to analyze the differences between patients with obstructive and perforated colonic cancer who managed with emergency curative surgery.


METHODS
Between January 1994 and December 2000, patients deemed to have undergone curative resection for complicated colonic cancer were considered for inclusion in the study. They were classified into 2 groups: patients with obstructive cancer (OC) and patients with perforated cancer (PC). The main end points were postsurgical outcomes and long-term overall survival, cancer-related survival, and tumor recurrence.


RESULTS
Of the 236 patients, surgery was deemed to be radical and performed with intent to cure in 155 patients (65.7%): 117 patients in the OC group and 38 patients in the PC group. No statistical differences were observed between the percentage of radical surgery between the 2 groups (P = .63). The overall postsurgical mortality rate was 12.2%: 14 patients in the OC group and 5 patients in the PC group (P = .839). Overall survival, probability of being free of recurrence, and cancer-related survival of the entire series were 64.57%, 67.72% and 73.03%, respectively. There were no differences between the 2 groups with respect to tumor recurrence, type of recurrence, overall survival, probability of being free of recurrence, and cancer-related survival at 5 years.


CONCLUSIONS
In our experience, patients with perforated colonic cancer do not seem to show worse long-term outcomes than those with OC. Studies with larger series are needed for further investigations.
Biondo
Sebastiano
S
Department of Surgery, Colorectal Unit, University Hospital of Bellvitge, University of Barcelona, Barcelona, Spain. sebastianobiondo@yahoo.com
Kreisler
Esther
E
Millan
Monica
M
Fraccalvieri
Domenico
D
Golda
Thomas
T
Martí Ragué
Joan
J
Salazar
Ramon
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods / Q000401:mortality; D003110:Colonic Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome