Intraoperative Tumor Perforation is Associated with Decreased 5-Year Survival in Colon Cancer: A Nationwide Database Study

Abstract

This nationwide study demonstrates that intraoperative tumor perforation in colon cancer is associated with statistically significant reduced long-term survival and increased postoperative mortality.

An investigation into tumor regression grade as a parameter for locally advanced rectal cancer and 5-year overall survival rate

“…Regarding factors related to 5-year RFS, this study found that poor differentiation (HR, 4.21), intraoperative tumor perforation (HR, 7.32), and PNI (HR, 4.13) were associated with inferior RFS. Particularly, intraoperative tumor perforation was clearly associated with worse oncologic outcomes; this finding is similar to that reported in prior studies [31,32]. Spilled tumor cells can regrow and recur and have a deleterious impact on survival.…”

Outcomes of patients with perforated colon cancer: A systematic review

“…Similarly, Daniels et al found a significant difference in 30-day mortality between PCC and non-perforated colon cancer patients of 15% vs 3%, respectively (p < 0.001) [11]. According to Bundgaard et al, free-perforation was associated with a higher 30-day mortality than contained perforation (26% vs 10%, p < 0.001, respectively) [4]. Zielinski et al also reported a higher 30-day mortality of 19% in free-perforation cases, as compared to 0% in patients with contained perforation [14].…”

“…This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [4] [12]. A Prospero search was performed and did not have a similar systematic review registered.…”

“…Five of the included studies had moderate risk of bias and six studies had low risk of bias. Two studies compared free-perforation and contained perforation [4,14], four articles compared PCC with obstructive colon cancer [8,15e17], and 4 articles compared PCC with no perforation [3,4,11,14]. Three articles that compared different treatment approaches of PCC were found.…”

“…When involving tumour necrosis this type of perforation is commonly contained [7,9]. Both main types of perforation are challenging to manage [3,4,9,10]. Perforation at the tumour site can also be caused by colonoscopy or endoscopic interventions such as biopsy or stenting, but these iatrogenic perforations are outside the scope of the present review.…”