title: Clinicopathological features of perforated colorectal cancer.
abstract: 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.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan. masatchmo@k5.dion.ne.jp
authors.forename: Masaichi
authors.initials: M
authors.lastname: Ogawa
authors.forename: Michiaki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Ken
authors.initials: K
authors.lastname: Eto
authors.forename: Takahiro
authors.initials: T
authors.lastname: Omachi
authors.forename: Makoto
authors.initials: M
authors.lastname: Kosuge
authors.forename: Ken
authors.initials: K
authors.lastname: Hanyu
authors.forename: Lohta
authors.initials: L
authors.lastname: Noaki
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Fujita
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D012189:Retrospective Studies