Surgical outcome in patients with gastrointestinal malignancies; a report from a large referral hospital, 2008-2010.
BACKGROUND
A considerable portion of gastrointestinal malignancies undergoes surgerywithout curative resection. This study was conducted to assess surgical outcomein patients with gastrointestinal cancers.


METHODS
We reviewed individuals with esophagus, stomach, colon and rectum cancersadmitted for surgical treatment after initial preoperative evaluations. Surgicaloutcome, stage of tumors and 1 and 5 years survival rate were assessedand analyzed.


RESULTS
Two hundred and fifty five patients with esophagus, stomach and colorectalmalignancies, who were admitted for surgical resection, were reviewed. Twohundred and twenty two patients were underwent surgery but tumor was not resectedin 41 cases (18.6%). Based on pathological assessment, stage of tumorswas III or IV in 108 individuals (48.9%). The proportion of tumor with advancedstage was significantly higher in patients with gastroesophageal cancersthan those with colorectal malignancies (62.6% versus 31.6%), p<0.0001). Theproportion of non-resectable tumor was also significantly higher in patientswith esophageal and gastric cancers (p=0.0001). Palliative surgery was donein 26.1% of patients treated by surgical resection. The proportion of palliativesurgery was significantly lower in patients with gastric cancer (p=0.001). 1 and5-year survival were significantly longer in colorectal cancer and those withcurative surgery (p=0.001). Survival of patients with palliative resection wasthe same as patient without tumor resection.


CONCLUSIONS
Despite preoperative evaluations, there are still a considerable proportionof patients who are diagnosed as inoperable during surgery. Further researchesseem to be necessary in order to provide more precise preoperative staging.Screening programs should also be considered for GI cancers in high-risk areas.It seems that palliative resection would not improve survival of patientswith advanced GI malignancies.
Associate Professor, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ahmadreza
A
Soroush
Alimentary tract; Malignancy; Surgical outcome