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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 3/2017

01-03-2017 | Original Article

Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients

Authors: Zhaomin Xu, Adan Z. Becerra, Christopher T. Aquina, Bradley J. Hensley, Carla F. Justiniano, Courtney Boodry, Alex A. Swanger, Reza Arsalanizadeh, Katia Noyes, John R. Monson, Fergal J. Fleming

Published in: Journal of Gastrointestinal Surgery | Issue 3/2017

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Abstract

Background

The purpose of this study was to examine the long-term overall survival (OS) of colon cancer patients who underwent emergent resection versus patients who were resected electively.

Methods

The 2006–2012 National Cancer Data Base was queried for colon cancer patients who underwent surgical resection. Emergent resection was defined as resection within 24 h of diagnosis. A mixed-effects logistic regression was used to estimate the effect of emergent resection on 30- and 90-day mortality. A propensity score-matched mixed-effects Cox proportional-hazards model was used to estimate the effect of emergent resection on 5-year OS.

Results

Two hundred fourteen thousand one hundred seventy-four patients met inclusion criteria, 30% of the cohort had an emergent resection. After controlling for patient and hospital factors, pathological stage, lymph node yield, margin status, and adjuvant chemotherapy, emergent resection was associated with increased odds of 30-day mortality (OR = 1.69, 95% CI = 1.60, 1.78) and hazard of death at 5 years (HR = 1.13, 95% CI = 1.09, 1.15) compared to elective resections.

Conclusion

Emergent resection for colon cancer is independently associated with poor short-term outcomes and decreased 5-year OS compared to elective resection. With 30% of cases in this study emergent, these findings underlie the importance of adherence to colon cancer screening guidelines to limit the need for emergent resections.
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Metadata
Title
Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients
Authors
Zhaomin Xu
Adan Z. Becerra
Christopher T. Aquina
Bradley J. Hensley
Carla F. Justiniano
Courtney Boodry
Alex A. Swanger
Reza Arsalanizadeh
Katia Noyes
John R. Monson
Fergal J. Fleming
Publication date
01-03-2017
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 3/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-017-3355-8

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