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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 5/2007

01-05-2007 | Original Article

The survival rate and prognostic factors in 26 perforated colorectal cancer patients

Authors: In Kyu Lee, Na Young Sung, Yoon Suk Lee, Sang Chul Lee, Won Kyung Kang, Hyeon Min Cho, Chang Hyeok Ahn, Do Sang Lee, Seong Taek Oh, Jun-Gi Kim, Hae Myung Jeon, Suk Kyun Chang

Published in: International Journal of Colorectal Disease | Issue 5/2007

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Abstract

Purpose

The treatment for perforated colorectal cancer is not easy and the prognosis for this disease is not so predictable. There are some controversies about performing radical operations because colorectal cancer perforation was considered as an advanced stage disease due to the possibility of tumor cell dissemination through the perforation site.

Methods

We selected and enrolled 26 patients with perforated colorectal cancers among the 1,227 patients who underwent operation for colorectal cancer. These cases were retrospectively analyzed by using their medical records and clinicopathological data.

Results

Twenty-eight cases (2.3%) with perforated colorectal cancers were studied and the overall operative mortality rate was 11%. The overall 5-year survival rate was 57.8% when excluding the operative mortality. The overall 5-year cancer-free survival rate was 52.8%. There were significant differences in the survival rate and the cancer-free survival rate between the stages (p=0.008 and p<0.001, respectively). A univariate analysis of the prognostic factors revealed that the number of the metastatic lymph nodes (p=0.018) and the perforation proximal to the cancer (p=0.005) were significantly correlated to worse survival, and the higher number of the metastatic lymph nodes was correlated to a poorer cancer-free survival rate (p<0.001).

Conclusion

For the perforated colorectal cancers, the stage, the perforation proximal to the cancer, and the number of the metastatic lymph nodes were correlated, with the survival and the cancer-free survival as factors of a poor prognosis. The surgical approach selected for perforated colorectal cancer should be in line with the principles of an appropriate cancer operation because the clinical pathway of perforated colorectal cancer is similar to that of uncomplicated colorectal cancer.
Literature
1.
Crowder VH Jr, Cohn I Jr (1967) Perforation in cancer of the colon and rectum. Dis Colon Rectum 10:415–420PubMed
2.
Mandava N, Kumar S, Pizzi WF, Aprile IJ (1996) Perforated colorectal carcinomas. Am J Surg 172:236–238PubMedCrossRef
3.
Chen HS, Sheen-Chen SM (2000) Obstruction and perforation in colorectal adenocarcinoma: an analysis of prognosis and current trends. Surgery 127:370–376PubMedCrossRef
4.
Tobaruela E, Camunas J, Enriquez-Navascues JM, Diez M, Martin A, Ratia T et al (1997) Medical factors in the morbidity and mortality associated with emergency colorectal surgery. Rev Esp Enferm Dig 89:13–22PubMed
5.
Kyllonen LE (1987) Obstruction and perforation complicating colorectal carcinoma. Acta Chir Scand 153:607–614PubMed
6.
American Joint Committee on Cancer (2002) AJCC cancer staging manual, 6th edn. Springer, Berlin Heidelberg New York
7.
Willett C, Tepper JE, Cohen A, Orlow E, Welch C (1985) Obstructive and perforative colonic carcinoma: patterns of failure. J Clin Oncol 3:379–384PubMed
8.
Steinberg SM, Barkin JS, Kaplan RS, Stablein DM (1986) Prognostic indicators of colon tumors. Cancer 57:1866–18670PubMedCrossRef
9.
Lehnert T, Buhl K, Dueck M, Hinz U, Herfarth C (2000) Two-stage radical gastrectomy for perforated gastric cancer. Eur J Surg Oncol 26:780–784PubMedCrossRef
10.
Kwon SJ, Park WC, Rhee JK (2003) Non-traumatic colon perforation. J Korean Surg Soc 64:49–55
11.
Sasaki LS, Allaben RD, Golwala R, Mittal VK (1995) Primary repair of colon injuries: a prospective randomized study. J Trauma 39:895–901PubMed
12.
Gonzales RP, Merlotti GJ, Holevar MR (1996) Colostomy in penetrating colon injury: is it necessary? J Trauma 41:271–275
13.
Mulherin JL, Sawyer JL (1975) Evaluation of three method for managing penetrating colon injuries. J Trauma 15:580–587PubMedCrossRef
14.
Biondo S, Perea MT, Rague JM, Pares D, Jaurrieta E (2001) One-stage procedure in non-elective surgery for diverticular disease complications. Colorectal Dis 3:42–45PubMedCrossRef
15.
Park UC, Chung SS, Kim KR, Seong MK, Yoon WH, Kim YJ et al (2004) Single-stage procedure with intraoperative colonoscopy and colonic irrigation in patients with obstructing left-sided colonic cancer. Int J Colorectal Dis 19:487–492PubMedCrossRef
16.
Radcliffe AG, Dudley HA (1983) Intraoperative antegrade irrigation of the large intestine. Surg Gynecol Obstet 156:721–723PubMed
17.
Duraker N, Bender O (1998) Intraoperative bowel irrigation improves anastomotic collagen metabolism in the left sided colonic obstruction but not covering colostomy. Int J Colorectal Dis 13:232–234PubMedCrossRef
18.
Tan SG, Nambiar R, Rauff A, Ngoi SS, Goh HS (1991) Primary resection and anastomosis in obstructed descending colon due to cancer. Arch Surg 126:748–751PubMed
19.
Murray JJ (1991) Nonelective colon resection: alternative to multistage resections. Surg Clin North Am 71:1187–1194PubMed
20.
Kim H, Lee KJ, Lee YJ, Suh KW (2003) Prognostic factors for generalized peritonitis secondary to colonic perforation. J Korean Soc Coloproctol 19:216–220
Metadata
Title
The survival rate and prognostic factors in 26 perforated colorectal cancer patients
Authors
In Kyu Lee
Na Young Sung
Yoon Suk Lee
Sang Chul Lee
Won Kyung Kang
Hyeon Min Cho
Chang Hyeok Ahn
Do Sang Lee
Seong Taek Oh
Jun-Gi Kim
Hae Myung Jeon
Suk Kyun Chang
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 5/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-006-0184-8

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