AI Article Synopsis
- Colorectal cancers that perforate are linked to a poor prognosis, prompting this study to evaluate outcomes in affected patients.
- Between 1996 and 2004, a review of 22 out of 848 colorectal cancer surgeries revealed that 69% of patients had potentially curative resections, but with a high complication rate (50% morbidity, 9% mortality).
- The overall 5-year survival rate was low at 17.4%, but improved to 32% when excluding stage IV patients or those who died shortly after surgery, highlighting that patients with curative resections had significantly better outcomes (36.9% survival) compared to those with noncurative procedures.
Article Abstract
Purpose: Colorectal cancers that manifest as a perforation are generally regarded as carrying a poor prognosis. We conducted this study to assess the outcome of colorectal cancer complicated by perforation.
Methods: Between 1996 and 2004, 848 patients underwent surgery for colorectal cancers in our department. We reviewed 22 (2.6%) consecutive patients who presented with perforation at one institution.
Results: Fifteen (69%) patients underwent potentially curative resection. The overall operative morbidity and mortality rates were 50% and 9%. The overall 5-year survival rate was 17.4%, although by excluding patients who either had stage IV disease at diagnosis or who died during or soon after surgery (n = 7), the 5-year survival rate increased to 32% (n = 15). Furthermore, the 5-year survival rate of patients who underwent a potentially curative resection (36.9%) was significantly better than that of those who underwent a noncurative resection (0%, P = 0.0093).
Conclusions: Perforating colorectal cancers are associated with high postoperative mortality and poor long-term survival. However, the intensive management of radical lymph node dissection and surgical resection are recommended to improve the long-term prognosis.
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| http://dx.doi.org/10.1007/s00595-009-4155-x | DOI Listing |
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