title: Effect of bowel obstruction on stage IV colorectal cancer.
abstract: Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide, with a high mortality rate, particularly among patients with advanced-stage disease complicated by bowel obstruction. The present study aimed to investigate the value of different surgical procedures and potential predictors of survival for patients with stage IV CRC, with or without bowel obstruction. Between August, 1994 and December, 2005, a total of 2,950 CRC patients were diagnosed and treated at our hospital. Among these, 381 patients had stage IV disease and were divided into two groups according to the presence (n=295) or absence (n=86) of bowel obstruction. The clinical data of all the patients with stage IV CRC were retrospectively analyzed and all the patients were followed up. Our results demonstrated statistically significant differences in gender, radical resection, histological type, ascites, tumor location, peritoneal and liver metastases between the obstruction and non-obstruction groups. We also observed that hepatic metastases and radical resection were factors associated with prognosis according to the univariate and multivariate analyses. Furthermore, the mean/median survival time was 49.4/21.6 and 37.2/17.1 months in the non-obstruction and obstruction groups, respectively. In conclusion, obstruction was not found to be an independent indicator of survival for patients with stage IV CRC, with patients in the obstruction group exhibiting a worse overall survival compared to those in the non-obstruction group, whereas active radical surgery significantly improved the prognosis of patients with stage IV CRC.
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Emergency Department, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510655, P.R. China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Tan
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, P.R. China.
authors.forename: Jun-Wen
authors.initials: JW
authors.lastname: Ye
authors.affiliation: Chongqing Hospital of Traditional Chinese Medicine, Jiangbei, Chongqing 400021, P.R. China ; Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi 330006, P.R. China.
authors.forename: Qingli
authors.initials: Q
authors.lastname: Zeng
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, P.R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, P.R. China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Wang
keywords: colorectal cancer; obstruction; radical resection; stage IV