title: Management of colorectal cancer in patients with cirrhosis: A retrospective, case-matched study of short- and long-term outcomes.
abstract: BACKGROUND
  Few studies have assessed access to postoperative chemotherapy and survival in cirrhotic patients with colorectal cancer. Aim of this study was to analyse short and long-term outcomes in these patients compared to non-cirrhotics.
  
  
  METHODS
  A retrospective, single-centre, comparative, case-matched study comparing 40 cirrhotic patients who had undergone colorectal resection between January 2006 and January 2014, and a matched cohort of 80 non-cirrhotic patients. Data collection included rate of postoperative outcomes, chemotherapy regimen, overall and disease-free 3-year survival.
  
  
  RESULTS
  Cirrhotics had more major postoperative complications than non-cirrhotics (57.5% vs. 26.5%, respectively; p=0.002) but no difference in anastomotic leakage (p=0.1); a higher mortality rate (p=0.0006) was observed in Child-Pugh class B patients. Cirrhotics had no difference in adjuvant chemotherapy rate compared to non-cirrhotics (55% vs. 65%, respectively p=0.8); 3-year overall survival was 71% in the Child A group vs. 92% in non-cirrhotics (p=0.03).
  
  
  CONCLUSIONS
  Despite a higher postoperative complication rate and a lower overall survival of cirrhotic patients compared to non-cirrhotics, cirrhosis had no impact on oncological outcomes and access/tolerance to postoperative chemotherapy. Thus cirrhosis should not be considered as a contraindication to curative treatment of colon cancer.
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Hospital, Amiens Cedex 01, France; Jules Verne University of Picardie, France; INSERM Unit U1088, Jules Verne University of Picardie, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Sabbagh
authors.affiliation: Jules Verne University of Picardie, France; Department of Pathology, Amiens University Hospital, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Chatelain
authors.affiliation: Jules Verne University of Picardie, France; Department of Hepatology and Gastroenterology, Amiens University Hospital, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Nguyen-Khac
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Hospital, Amiens Cedex 01, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rebibo
authors.affiliation: Department of Hepatology and Gastroenterology, Amiens University Hospital, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Joly
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens University Hospital, Amiens Cedex 01, France; Jules Verne University of Picardie, France; EA4294, Jules Verne University of Picardie, France; Clinical Research Centre, Amiens University Hospital, France. Electronic address: regimbeau.jean-marc@chu-amiens.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D019468:Disease Management; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Cirrhotic; Colon; Morbidity; Rectum; Survival