Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients

Xu, Zhaomin; Becerra, Adan Z.; Aquina, Christopher T.; Hensley, Bradley J.; Justiniano, Carla F.; Boodry, Courtney I.; Swanger, Alex A.; Arsalani‐Zadeh, Reza; Noyes, Katia; Monson, J. R. T.; Fleming, Fergal J.

doi:10.1007/s11605-017-3355-8

Cited by 52 publications

(61 citation statements)

References 39 publications

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“…Our study confirmed similar findings, showing that 28 patients (41%) with CCC presented with clinical stage III or IV. Other studies have also reported advanced stages in patients undergoing emergency surgical treatment 6,7,22.…”

Section: Discussionmentioning

confidence: 87%

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Outcomes of Elderly Patients Undergoing Emergency Surgery for Complicated Colorectal Cancer: A Retrospective Cohort Study

Menegozzo¹,

Teixeira-Júnior²,

Netto³

et al. 2019

Clinics

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OBJECTIVE: Colorectal cancer is one of the most frequent types of malignant neoplasms. Age is a risk factor for this disease, with 75% of cases diagnosed in patients older than 65 years. Complications such as obstruction, hemorrhage, and perforation are present in more than one-third of cases and require emergency treatment. We aim to analyze the profile of elderly patients undergoing surgery for complicated colorectal cancer, and to evaluate factors related to worse short-term prognosis. METHODS: A retrospective analysis of patients who underwent emergency surgical treatment for complicated colorectal cancer was performed. Demographics, clinical, radiological and histological data were collected. RESULTS: Sixty-seven patients were analyzed. The median age was 72 years, and almost half (46%) of the patients were female. Obstruction was the most prevalent complication at initial presentation (72%). The most common sites of neoplasia were the left and sigmoid colon in 22 patients (32.8%), and the right colon in 17 patients (25.4%). Resection was performed in 88% of cases, followed by primary anastomosis in almost half. The most frequent clinical stages were II (48%) and III (22%). Forty-three patients (65.7%) had some form of postoperative complication. Clavien-Dindo grades 1, 2, and 4, were the most frequent. Complete oncologic resection was observed in 80% of the cases. The thirty-day mortality rate was 10.4%. Advanced age was associated with worse morbidity and mortality. CONCLUSION: Elderly patients with complicated colorectal cancer undergoing emergency surgery have high morbidity and mortality rates. Advanced age is significantly associated with worse outcomes.

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Section: Discussionmentioning

confidence: 87%

“…Despite screening methods, up to 43% of patients will develop some form of complication including obstruction, perforation or hemorrhage 4-7. Emergency surgery has a direct impact on results.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Elderly Patients Undergoing Emergency Surgery for Complicated Colorectal Cancer: A Retrospective Cohort Study

Menegozzo¹,

Teixeira-Júnior²,

Netto³

et al. 2019

Clinics

View full text Add to dashboard Cite

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“…An emergency colectomy for perforation or obstruction is a stronger prognostic factor than a pathological finding of perforation [28].…”

Section: Clinical Presentationmentioning

confidence: 97%

Adjuvant Chemotherapy for Stage II Colon Cancer

Rebuzzi

Pesola

Martelli

et al. 2020

Cancers

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In stage II colon cancer management, surgery alone has shown a high cure rate (about 80%), and the role of adjuvant chemotherapy is still a matter of debate. Patients with high-risk features (T4, insufficient nodal sampling, grading, etc.) have a poorer prognosis and, usually, adjuvant chemotherapy is recommended. The purpose of the present study is to highlight and discuss what is still unclear and not completely defined from the previous trials regarding risk stratification and therapeutic benefit of adjuvant chemotherapy. With all the limitations of generalizing, we make the effort of trying to quantify the relative contribution of each prognostic factor and the benefit of adjuvant chemotherapy for stage II colon cancer. Finally, we propose a decision algorithm with the aim of summarizing the current evidence and translating it to clinical practice.

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“…A previous meta-analysis including 1062 patients reported 87% of unresectable stage IV patients with tumor-related complication required surgical intervention, thereby underlining the importance of PTR to such patients [ 23 ]. However, emergent surgery has been proved to be associated with the great risk and poor oncological outcome [ 24 – 26 ]. Besides, a symptomatic obstruction that requires surgery occurs in approximately 20% of patients before death [ 11 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Individualized prediction of survival benefit from primary tumor resection for patients with unresectable metastatic colorectal cancer

Jiang

et al. 2020

World J Surg Onc

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Background: The impact of primary tumor resection (PTR) on the prognosis of unresectable metastatic colorectal cancer (mCRC) patients remains debatable. We aimed to develop several prognostic nomograms which could be useful in predicting whether patients might benefit from PTR or not. Methods: Patients diagnosed as mCRC without resected metastasis were identified from the Surveillance Epidemiology and End Results database and randomly assigned into two groups: a training cohort (6369 patients) and a validation cohort (2774 patients). Univariate and multivariable Cox analyses were performed to identify the independent predictors and construct nomograms that could independently predict the overall survival (OS) of unresectable mCRC patients in PTR and non-PTR groups, respectively. The performance of these nomograms was assessed by the concordance index (C-index), calibration curves, and decision curve analysis (DCA). Results: Based on the result of univariate and multivariable Cox analyses, two nomograms were respectively constructed to predict the 1-year OS rates of unresectable mCRC patients when receiving PTR and not. The first one included age, gender, tumor grade, proximal colon, N stage, CEA, chemotherapy, radiotherapy, histology type, brain metastasis, liver metastasis, lung metastasis, and bone metastasis. The second nomogram included age, race, tumor grade, primary site, CEA, chemotherapy, brain metastasis, and bone metastasis. These nomograms showed favorable sensitivity with the C-index range of 0.700-0.725. The calibration curves and DCAs also exhibited adequate fit and ideal net benefits in prognosis prediction and clinical application. Conclusions: These practical prognosis nomograms could assist clinicians in making appropriate treatment decisions to effectively manage the disease.

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Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients

Cited by 52 publications

References 39 publications

Outcomes of Elderly Patients Undergoing Emergency Surgery for Complicated Colorectal Cancer: A Retrospective Cohort Study

Outcomes of Elderly Patients Undergoing Emergency Surgery for Complicated Colorectal Cancer: A Retrospective Cohort Study

Adjuvant Chemotherapy for Stage II Colon Cancer

Individualized prediction of survival benefit from primary tumor resection for patients with unresectable metastatic colorectal cancer

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