Clinicopathological features of perforated colorectal cancer.
The aim of this retrospective study was to determine clinicopathological factors pertinent to the prognosis of perforated colorectal cancer (PCRC).


METHODS
A retrospective review of clinical records of 17 cases of emergency primary resection for PCRC (stage IIIa in 2, stage IIIb in 6 and stage IV in 9) was performed.


RESULTS
The 5-year survival rate was 31% (31% for stage III and 12% for stage IV). When compared with non-PCRC (533 cases) in stage III (78.8%) or stage IV (14.8%), the 5-year survival rate of stage III perforated colorectal cancer was clearly worse (p<0.01) than the non-perforated counterpart. For stage IV, however, the two groups had a similar prognosis. MST of the PCRC was 31 months for stage III and 12 months for stage IV. Approximately half of the recurrence pattern of stage III (75%), or stage IV (44%) PCRC was peritoneal carcinomatosis. As for the type of operations performed, Hartmann's procedure was the preferred technique (71%), for which mortality and morbidity rate were both low.


CONCLUSIONS
Because of the high incidence of peritoneal carcinomatosis and low 5-year survival rate, stage III PCRC should be regarded as a stage IV disease, for which postoperative chemotherapy seems essential.
Ogawa
Masaichi
M
Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan. masatchmo@k5.dion.ne.jp
Watanabe
Michiaki
M
Eto
Ken
K
Omachi
Takahiro
T
Kosuge
Makoto
M
Hanyu
Ken
K
Noaki
Lohta
L
Fujita
Tetsuji
T
Yanaga
Katsuhiko
K
D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D012189:Retrospective Studies