title: Clinicopathologic characteristics and outcomes of patients with obstructive colorectal cancer.
abstract: OBJECTIVE
  The aim of this retrospective study was to analyze the clinicopathologic characteristics and short-term and long-term outcomes of colorectal cancer patients with obstruction compared to those of non-obstructive colorectal cancer patients.
  
  
  METHODS
  Between January 1998 and December 2005, 1,672 colorectal cancer patients undergoing operation were enrolled in this study. Patients were classified into two groups according to the presentation: patients with complete obstructive colorectal cancer (COC, n = 215) receiving emergency procedures and patients with non-obstructive colorectal cancer (NOC, n = 1,457) receiving elective procedures. The data on the clinicopathologic characteristics and short-term and long-term outcomes of patients were analyzed retrospectively.
  
  
  RESULTS
  Among 1,672 colorectal cancer patients, 215 cases presented with complete obstruction. The distribution of tumor location and size, macroscopic type, depth of invasion, liver metastasis, peritoneal carcinomatosis, and TNM stage were found to be different between the COC and NOC groups. Logistic regression analysis showed that tumor location, depth of invasion, and peritoneal carcinomatosis were independent factors associated with obstruction. Patients with obstruction had an increased risk of death by a factor of 2.251 compared to patients without obstruction. Peritoneal carcinomatosis and TNM stage were independent factors for the survival of the COC group. Obstruction, peritoneal carcinomatosis, tumor macroscopic type, and TNM stage were independent indicators for postoperative recurrence. Postoperative mortality was significantly higher in the COC group than the NOC group. The overall 5- and 10-year survival rates in the COC group were 47.8% and 42.8%, respectively, compared to 67.2% and 59.8% in the NOC group, respectively (p < 0.05). The postoperative recurrence rates were 43.1% in the COC group and 32.8% in the NOC group (p < 0.05).
  
  
  CONCLUSIONS
  Obstruction is an independent indicator for the survival and postoperative recurrence for patients with colorectal cancer. Patients in the COC group have worse overall survival with high postoperative recurrence rate compared to those in the NOC group.
authors.affiliation: Section of Colon and Rectum Surgery, Department of Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University (Guangdong Gastrointestinal and Anal Hospital), 26 Yuancun Erheng Road, Guangzhou 510655, People's Republic of China.
authors.forename: Zuli
authors.initials: Z
authors.lastname: Yang
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Kang
authors.forename: Jun
authors.initials: J
authors.lastname: Xiang
authors.forename: Junsheng
authors.initials: J
authors.lastname: Peng
authors.forename: Ji
authors.initials: J
authors.lastname: Cui
authors.forename: Yihua
authors.initials: Y
authors.lastname: Huang
authors.forename: Jianping
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003108:Colonic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D055815:Young Adult