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01-09-2019 | Colon Cancer | Original Article

Prognostic factors and patterns of recurrence after emergency management for obstructing colon cancer: multivariate analysis from a series of 2120 patients

Authors: Gilles Manceau, MD-PhD, Thibault Voron, MD, Diane Mege, MD-PhD, Valérie Bridoux, MD-PhD, Zaher Lakkis, MD, Aurélien Venara, MD, Laura Beyer-Berjot, MD-PhD, Solafah Abdalla, MD, Igor Sielezneff, MD-PhD, Jeremie H Lefèvre, MD-PhD, Mehdi Karoui, MD-PhD, On behalf of the AFC (French Surgical Association) Working Group

Published in: Langenbeck's Archives of Surgery | Issue 6/2019

Abstract

Purpose

At equal TNM stage, obstructing colon cancer (OCC) is associated with worse prognosis in comparison with uncomplicated cancer. Our aim was to identify prognostic factors of overall (OS) and disease-free survival (DFS) in patients treated for OCC.

Methods

From 2000 to 2015, 2325 patients were treated for OCC in French surgical centers, members of the French National Surgical Association (AFC). Patients with palliative management were excluded. The main endpoints were OS and DFS. A multivariate analysis, using Cox proportional hazards regression model, was performed to determine independent prognostic factors.

Results

The cohort included 2120 patients. The median of follow-up was 13.2 months. In multivariate analysis, age > 75 years, ASA score ≥ 3, ECOG score ≥ 3, right-sided colon cancer, presence of synchronous metastases, anastomotic leakage, and absence of adjuvant chemotherapy were independent OS factors. Age > 75 years, ASA score ≥ 3, right-sided colon cancer, presence of synchronous metastases, and absence of postoperative chemotherapy were independent factors of poor OS after exclusion of patients who died postoperatively. Age ≥ 75 years, ASA score ≥ 3, ECOG score ≥ 3, right-sided colon cancer, lymph node involvement, presence of vascular, lymphatic or perineural invasion, less than 12 harvested lymph nodes, and absence of adjuvant chemotherapy were independent DFS factors.

Conclusions

Management of OCC should take into account prognostic factors related to the patient (age, comorbidities), tumor location, and tumor stage. Adjuvant chemotherapy administration plays an important role. For patients undergoing initial defunctionning stoma, neoadjuvant chemotherapy could be an option to improve prognosis.

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Title: Prognostic factors and patterns of recurrence after emergency management for obstructing colon cancer: multivariate analysis from a series of 2120 patients
Authors: Gilles Manceau, MD-PhD
Thibault Voron, MD
Diane Mege, MD-PhD
Valérie Bridoux, MD-PhD
Zaher Lakkis, MD
Aurélien Venara, MD
Laura Beyer-Berjot, MD-PhD
Solafah Abdalla, MD
Igor Sielezneff, MD-PhD
Jeremie H Lefèvre, MD-PhD
Mehdi Karoui, MD-PhD
On behalf of the AFC (French Surgical Association) Working Group
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Colon Cancer
Colon Cancer
Cytostatic Therapy
Published in: Langenbeck's Archives of Surgery / Issue 6/2019
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-019-01819-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prognostic factors and patterns of recurrence after emergency management for obstructing colon cancer: multivariate analysis from a series of 2120 patients

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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