title: Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients.
abstract: The purpose of this study was to examine the long-term overall survival (OS) of colon cancer patients who underwent emergent resection versus patients who were resected electively.
  
  
  
  The 2006-2012 National Cancer Data Base was queried for colon cancer patients who underwent surgical resection. Emergent resection was defined as resection within 24 h of diagnosis. A mixed-effects logistic regression was used to estimate the effect of emergent resection on 30- and 90-day mortality. A propensity score-matched mixed-effects Cox proportional-hazards model was used to estimate the effect of emergent resection on 5-year OS.
  
  
  
  Two hundred fourteen thousand one hundred seventy-four patients met inclusion criteria, 30% of the cohort had an emergent resection. After controlling for patient and hospital factors, pathological stage, lymph node yield, margin status, and adjuvant chemotherapy, emergent resection was associated with increased odds of 30-day mortality (OR = 1.69, 95% CI = 1.60, 1.78) and hazard of death at 5 years (HR = 1.13, 95% CI = 1.09, 1.15) compared to elective resections.
  
  
  
  Emergent resection for colon cancer is independently associated with poor short-term outcomes and decreased 5-year OS compared to elective resection. With 30% of cases in this study emergent, these findings underlie the importance of adherence to colon cancer screening guidelines to limit the need for emergent resections.
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA. zhaomin_xu@urmc.rochester.edu.
authors.forename: Zhaomin
authors.identifier: 0000-0002-7348-9201
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Public Health Sciences, Division of Epidemiology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Adan Z
authors.initials: AZ
authors.lastname: Becerra
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Aquina
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Hensley
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA.
authors.forename: Carla F
authors.initials: CF
authors.lastname: Justiniano
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Boodry
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA.
authors.forename: Alex A
authors.initials: AA
authors.lastname: Swanger
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Arsalanizadeh
authors.affiliation: Department of Epidemiology and Environmental Health, Division of Health Services Policy and Practice, State University of New York at Buffalo, School of Public Health and Health Professions, Buffalo, NY, USA.
authors.forename: Katia
authors.initials: K
authors.lastname: Noyes
authors.affiliation: Center for Colon and Rectal Surgery, Florida Hospital Medical Group, University of Central Florida, College of Medicine, Orlando, FL, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Monson
authors.affiliation: Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA.
authors.forename: Fergal J
authors.initials: FJ
authors.lastname: Fleming
mesh_terms: D000368:Aged; D003082:Colectomy / Q000401:mortality*; D003110:Colonic Neoplasms / Q000401:mortality* / Q000601:surgery*; D016208:Databases, Factual; D017558:Elective Surgical Procedures / Q000401:mortality; D004630:Emergencies / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
keywords: Colectomy; Colon cancer; Colonic neoplasm; Emergencies; Outcomes research