title: [Problems in the Treatment of Stage Ⅲ Colorectal Cancer with Perforation].
abstract: We retrospectively investigated clinical outcome and treatment strategies in Stage Ⅲcolorectal cancer patients who underwent emergency surgery because of tumor-related perforation. We compared the clinical outcome of 6 patients (perforation group) who underwent emergency surgery for colonic perforation due to Stage Ⅲ colorectal cancer with 12 matched patients (matching group) who underwent elective colorectal surgery, between April 1998 and March 2012. Patients in the perforation group underwent colostomy procedures more frequently (p=0.02), had longer operative times (p=0.02), and more bleeding (p=0.04) than those in the matching group. There was no significant difference between the groups in terms of the introduction rate of chemotherapy, recurrence rate, or recurrence pattern. The 3-year disease-free survival rate was 44% in the perforation group and 81% in the matching group, resulting in no significant differences between these groups (p=0.28). The 3-year disease-free survival rates in the perforation and the matching groups were 44% and 81%, respectively (p=0.07). The 3-year overall survival rates in the perforation and the matching groups were 17% and 81%, respectively (p<0.01). The 3-year overall survival rate of patients who received adjuvant chemotherapy was 50% in the perforation group and 88%in the matching group (p=0.03). We concluded that patients with perforated Stage Ⅲ colorectal cancer had a significantly poorer prognosis compared with patients with non-perforated Stage Ⅲ colorectal cancer.
authors.affiliation: Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Onozawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kumamoto
authors.forename: Takeaki
authors.initials: T
authors.lastname: Matsuzawa
authors.forename: Toru
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Jun
authors.initials: J
authors.lastname: Sobajima
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kumagai
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Erito
authors.initials: E
authors.lastname: Mochiki
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D015179:Colorectal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003125:Colostomy; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016896:Treatment Outcome