Long-term outcomes and prognostic factors of patients with obstructive colorectal cancer: A multicenter retrospective cohort study.
OBJECTIVE
To investigate the long-term oncologic outcomes and prognostic factors in patients with obstructive colorectal cancer (CRC) at multiple Japanese institutions.


METHODS
We identified 362 patients diagnosed with obstructive colorectal cancer from January 1, 2002 to December 31, 2012 in Yokohama Clinical Oncology Group's department of gastroenterological surgery. Among them, 234 patients with stage II/III disease who had undergone surgical resection of their primary lesions were analyzed, retrospectively. We report the long-term outcomes, the risk factors for recurrence, and the prognostic factors.


RESULTS
The five-year disease free survival and cancer-specific survival were 50.6% and 80.3%, respectively. A multivariate analysis showed the ASA-PS (HR = 2.23, P = 0.026), serum Albumin ≤ 4.0 g/dL (HR = 2.96, P = 0.007), T4 tumor (HR = 2.73, P = 0.002) and R1 resection (HR = 6.56, P = 0.02) to be independent risk factors for recurrence. Furthermore, poorly differentiated cancers (HR = 6.28, P = 0.009), a T4 tumor (HR = 3.46, P = 0.011) and R1 resection (HR = 6.16, P = 0.006) were independent prognostic factors in patients with obstructive CRC.


CONCLUSIONS
The outcomes of patients with obstructive CRC was poor. T4 tumor and R1 resection were found to be independent prognostic factors for both recurrence and survival in patients with obstructive CRC.
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Ishibe
I
Atsushi
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Ota
O
Mitsuyoshi
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Yamaguchi
Y
Kazuya
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Kaida
K
Syuhei
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Kamiya
K
Noriyuki
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Momiyama
M
Masashi
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Watanabe
W
Akira
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Sekizawa
S
Kentaro
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Kamimukai
K
Nobuyuki
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Sugimasa
S
Natsuko
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Watanabe
W
Jun
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Ichikawa
I
Yasushi
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Kunisaki
K
Chikara
Ishibe Atsushi, Endo Itaru, Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Endo
E
Itaru
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation; D017024:Chemotherapy, Adjuvant; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
Obstructive colorectal cancer; Prognostic factor; Survival