Delayed surgical resection of primary left‐sided obstructing colon cancer is associated with improved short‐ and long‐term outcomes

• Published in: Journal of surgical oncology Vol. 124; no. 7; pp. 1146 - 1153
• Main Authors: de Roos, Marnix A. J., Hugen, Niek, Hazebroek, Eric J., Spillenaar Bilgen, Ernst J.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc 01.12.2021
• Subjects: Colorectal cancer; decompressing stoma; emergency resection; obstructive colon cancer; SEMS; time‐interval
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.26632

Background and Objectives It is unclear what time interval is optimal between presentation and surgical resection of left‐sided obstructive colon cancer (LSOCC). This study aims to determine whether a time interval beyond 4 weeks is associated with a better outcome. Materials and Methods Consecutive patients who underwent surgical resection of LSOCC between January 2010 and December 2019 were collected from a prospective database. Patients were divided into three groups: (1) Emergency resection (ER group), (2) surgery in less than 4 weeks (early group), and (3) surgery beyond 4 weeks (late group). Results The ER group consisted of 74 (44.0%), the early group of 38 (22.6%), and the late group of 56 (33.3%) patients. Ninety‐day mortality was lower in the Late group than in the ER group and the early group (1.8% vs. 12.2%, p = 0.029 vs. 15.3%, p = 0.011). In the late group 5‐year recurrence‐free survival was better than in the early group (82.1% vs. 63.2%, p = 0.039) and 5‐year overall survival (OS) was better than in the ER group (75% vs. 51.4%, p = 0.021). Definitive surgical resection beyond 4 weeks was an independent prognostic factor for OS (Hazard ratio: 0.402, 95% CI: 0.204–0.793, p = 0.009). Conclusion In this study surgical resection beyond 4 weeks after presentation seems to have a better short‐ and long‐term outcome for LSOCC.