Problems in the Treatment of Stage Ⅲ Colorectal Cancer with Perforation

• Published in: Gan to kagaku ryoho Vol. 42; no. 12; p. 2245
• Main Authors: Onozawa, Hisashi, Kumamoto, Kensuke, Matsuzawa, Takeaki, Ishiguro, Toru, Sobajima, Jun, Fukuchi, Minoru, Kumagai, Youichi, Ishibashi, Keiichiro, Mochiki, Erito, Ishida, Hideyuki
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.11.2015
• Subjects: Adult; Aged; Aged, 80 and over; Blood Loss, Surgical; Colorectal Neoplasms - complications; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Colostomy; Female; Humans; Intestinal Perforation - etiology; Intestinal Perforation - surgery; Male; Middle Aged; Neoplasm Staging; Treatment Outcome
• ISSN: 0385-0684

We retrospectively investigated clinical outcome and treatment strategies in Stage Ⅲcolorectal cancer patients who underwent emergency surgery because of tumor-related perforation. We compared the clinical outcome of 6 patients (perforation group) who underwent emergency surgery for colonic perforation due to Stage Ⅲ colorectal cancer with 12 matched patients (matching group) who underwent elective colorectal surgery, between April 1998 and March 2012. Patients in the perforation group underwent colostomy procedures more frequently (p=0.02), had longer operative times (p=0.02), and more bleeding (p=0.04) than those in the matching group. There was no significant difference between the groups in terms of the introduction rate of chemotherapy, recurrence rate, or recurrence pattern. The 3-year disease-free survival rate was 44% in the perforation group and 81% in the matching group, resulting in no significant differences between these groups (p=0.28). The 3-year disease-free survival rates in the perforation and the matching groups were 44% and 81%, respectively (p=0.07). The 3-year overall survival rates in the perforation and the matching groups were 17% and 81%, respectively (p<0.01). The 3-year overall survival rate of patients who received adjuvant chemotherapy was 50% in the perforation group and 88%in the matching group (p=0.03). We concluded that patients with perforated Stage Ⅲ colorectal cancer had a significantly poorer prognosis compared with patients with non-perforated Stage Ⅲ colorectal cancer.