Surgical treatment and overall survival in patients with right-sided obstructing colon cancer-a nationwide retrospective cohort study.

Autor: Boeding JRE; Department of Surgery, Amphia Hospital, Breda, The Netherlands. jeskeboeding@gmail.com.; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. jeskeboeding@gmail.com., Elferink MAG; Department of Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands., Tanis PJ; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.; Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., de Wilt JHW; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., Gobardhan PD; Department of Surgery, Amphia Hospital, Breda, The Netherlands., Verhoef C; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Schreinemakers JMJ; Department of Surgery, Amphia Hospital, Breda, The Netherlands.
Jazyk: angličtina
Zdroj: International journal of colorectal disease [Int J Colorectal Dis] 2023 Oct 05; Vol. 38 (1), pp. 248. Date of Electronic Publication: 2023 Oct 05.
DOI: 10.1007/s00384-023-04541-3
Abstrakt: Purpose: The aim of this study was to compare baseline characteristics, 90-day mortality and overall survival (OS) between patients with obstructing and non-obstructing right-sided colon cancer at a national level.
Methods: All patients who underwent resection for right-sided colon cancer between January 2015 and December 2016 were selected from the Netherlands Cancer Registry and stratified for obstruction. Primary outcome was 5-year OS after excluding 90-day mortality as assessed by the Kaplan-Meier and multivariable Cox regression analysis.
Results: A total of 525 patients (7%) with obstructing and 6891 patients (93%) with non-obstructing right-sided colon cancer were included. Patients with right-sided obstructing colon cancer (OCC) were older and had more often transverse tumour location, and the pathological T and N stage was more advanced than in those without obstruction (p < 0.001). The 90-day mortality in patients with right-sided OCC was higher compared to that in patients with non-obstructing colon cancer: 10% versus 3%, respectively (p < 0.001). The 5-year OS of those surviving 90 days postoperatively was 42% in patients with OCC versus 73% in patients with non-obstructing colon cancer, respectively (p < 0.001). Worse 5-year OS was found in patients with right-sided OCC for all stages. Obstruction was an independent risk factor for decreased OS in right-sided colon cancer (HR 1.79, 95% CI 1.57-2.03).
Conclusion: In addition to increased risk of postoperative mortality, a stage-independent worse 5-year OS after excluding 90-day mortality was found in patients with right-sided OCC compared to patients without obstruction.
(© 2023. The Author(s).)
Databáze: MEDLINE
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