The Prognostic Impact of Obstructed Colorectal Cancer.

, Jung, Hwa Kyung; , Jung, Sang Hun; , Kim, Jae Hwang; , Shim, Min Chul

doi:2008.24.6.479

Original Article

Journal of the Korean Society of Coloproctology 2008;24(6):479-486.
DOI: https://doi.org/10.3393/jksc.2008.24.6.479

The Prognostic Impact of Obstructed Colorectal Cancer.

Jung, Hwa Kyung , Jung, Sang Hun , Kim, Jae Hwang , Shim, Min Chul

Department of Surgery, College of Medicine, Yeungnam University, Daegu, Korea. phenix78@hanmail.net

Abstract

PURPOSE
An obstructed colorectal cancer (OB) has a poorer survival than a non-obstructed cancer (NOB). This study examined the prognostic impact of bowel obstruction on colorectal cancer.
METHODS
From December 1999 to December 2005, patients undergoing single stage operation for OB were examined prospectively. OB (n= 193) was compared with a NOB (n=444) used in a primary tumor resection during the same period. 637 colorectal cancers were examined in this study.
RESULTS
The overall operative mortality was 21 (3.3%) and the postoperative mortality was significantly higher in the OB (OB: 16, 8.3%) group than in the NOB (NOB: 5, 1.1%) group. The proportion of OB was higher in the left-colon (52.8%) than in the right colon (16.0%) and rectum (31.1%, P<0.001). However, OB was associated with an older age (P=0.013). The proportion of advanced tumor stage was higher in OB (II: 35.8%, III: 39.5%, IV: 24.7%) than in NOB (II: 53.2%, III: 35.8%, IV: 11.0%, P<0.001). The 5-year cancer-related survival for OB was worse than NOB (OB: 77.3%, NOB: 57.8%, P<0.05). However, in the cases of a colorectal cancer performed curative resection (stage II and III), the survival for OB was not worse than NOB: stage II (OB: 82.8%, NOB: 92.2%, P=0.24), stage III (OB: 65.2%, NOB: 56.9%, P=0.43).
CONCLUSIONS
OB has older and more advanced disease characteristics. However, if an oncologically curative resection is performed, the survival for OB is similar to that of a NOB.

Key Words: Obstructed colorectal cancer; Cancer related survival rate