Long-term outcomes after postponing surgery to optimise patients with acute right-sided obstructing colon cancer.

Autor: Lockhorst EW; Department of Surgery, Amphia Hospital, Breda, the Netherlands; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. Electronic address: e.lockhorst@erasmusmc.nl., Boeding JRE; Department of Surgery, Amphia Hospital, Breda, the Netherlands; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., Wullaert L; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., Coebergh van den Braak RRJ; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., Rijken AM; Department of Surgery, Amphia Hospital, Breda, the Netherlands., Verhoef C; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., Gobardhan PD; Department of Surgery, Amphia Hospital, Breda, the Netherlands., Schreinemakers JMJ; Department of Surgery, Amphia Hospital, Breda, the Netherlands.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Dec 06; Vol. 51 (2), pp. 109521. Date of Electronic Publication: 2024 Dec 06.
DOI: 10.1016/j.ejso.2024.109521
Abstrakt: Aim: To retrospectively analyse the short- and long-term oncological, morbidity and mortality outcomes in patients diagnosed with acute right-sided obstructing colon cancer. Patients who underwent pre-optimisation prior to the oncological resection were compared to patients who did not undergo pre-optimisation.
Methods: All consecutive patients with right-sided obstructing colon cancer, either with a high clinical suspicion or confirmed diagnosis by histological analysis, who underwent curative-intent treatment between March 2013 and December 2020 were included. Patients were divided into two groups: an optimised group and a non-optimised group. Preoperative optimisation included additional nutrition, physiotherapy, and, if needed, bowel decompression. Data about disease-free survival and mortality were collected up to three years after surgery.
Results: Sixty-two patients were included. Thirty patients underwent the optimisation protocol before postponed surgery, and 32 patients received emergency surgery, without optimisation (surgery performed with a median of 9.6 days versus 22 h after admission). The postoperative complication rate was significantly lower in the optimisation group (50 % vs 78 %, p = 0.033). No significant differences were found in the 90-day mortality rate (7 % vs 13 %, p = 0.672) and three-year overall survival rate (43 % vs 56 %, p = 0.49). After three years, sixteen (53 %) patients in the optimised group and twenty (63 %) in the non-optimised were deceased (p = 0.672).
Conclusion: Postponing the surgery with preoperative optimisation in patients with obstructing right-sided colon cancer results in a significantly lower 90-day complication rate and suggests no negative effect on survival rates compared to an acute resection. Although, further research with a larger sample size is needed.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: PD Gobardhan reports financial support was provided by ‘Amphia Wetenschapsfonds’ (Amphia hospital research fund) for the preparation of this manuscript. The other authors, declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: