Clinicopathological Features of Perforated Colorectal Cancer

• Published in: Anticancer research Vol. 29; no. 5; pp. 1681 - 1684
• Main Authors: OGAWA, Masaichi, WATANABE, Michiaki, ETO, Ken, OMACHI, Takahiro, KOSUGE, Makoto, HANYU, Ken, NOAKI, Lohta, FUJITA, Tetsuji, YANAGA, Katsuhiko
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.05.2009
• Subjects: Biological and medical sciences; Colorectal Neoplasms - pathology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Medical sciences; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Colonic disease; Rectal disease; Cancerology; Clinico-pathological features; Hartmann's procedure; Perforation; Colorectal cancer; Digestive diseases; Intestinal disease; Malignant tumor; Cancer
• ISSN: 0250-7005; 1791-7530

The aim of this retrospective study was to determine clinicopathological factors pertinent to the prognosis of perforated colorectal cancer (PCRC). Patients and Methods: A retrospective review of clinical records of 17 cases of emergency primary resection for PCRC (stage IIIa in 2, stage IIIb in 6 and stage IV in 9) was perfomed. Result: The 5-year survival rate was 31% (31% for stage III and 12% for stage IV). When compared with non-PCRC (533 cases) in stage III (78.8%) or stage IV (14.8%), the 5-year survival rate of stage III perforated colorectal cancer was clearly worse (p<0.01) than the non-perforated counterpart. For stage IV, however, the two groups had a similar prognosis. MST of the PCRC was 31 months for stage III and 12 months for stage IV. Approximately half of the recurrence pattern of stage III (75%), or stage IV (44%) PCRC was peritoneal carcinomatosis. As for the type of operations performed, Hartmann's procedure was the preferred technique (71%), for which mortality and morbidity rate were both low. Conclusion: Because of the high incidence of peritoneal carcinomatosis and low 5-year survival rate, stage III PCRC should be regarded as a stage IV disease, for which postoperative chemotherapy seems essential.