1. Long-term outcomes and prognostic factors of patients with obstructive colorectal cancer: A multicenter retrospective cohort study.
- Author
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Atsushi I, Mitsuyoshi O, Kazuya Y, Syuhei K, Noriyuki K, Masashi M, Akira W, Kentaro S, Nobuyuki K, Natsuko S, Jun W, Yasushi I, Chikara K, and Itaru E
- Subjects
- Adult, Aged, Aged, 80 and over, Cell Differentiation, Chemotherapy, Adjuvant, Colorectal Neoplasms complications, Colorectal Neoplasms diagnosis, Colorectal Neoplasms mortality, Disease Progression, Disease-Free Survival, Female, Humans, Intestinal Obstruction diagnosis, Intestinal Obstruction etiology, Intestinal Obstruction mortality, Japan, Kaplan-Meier Estimate, Male, Margins of Excision, Middle Aged, Multivariate Analysis, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Colectomy adverse effects, Colectomy mortality, Colorectal Neoplasms surgery, Intestinal Obstruction surgery
- Abstract
Aim: To investigate the long-term oncologic outcomes and prognostic factors in patients with obstructive colorectal cancer (CRC) at multiple Japanese institutions., Methods: We identified 362 patients diagnosed with obstructive colorectal cancer from January 1, 2002 to December 31, 2012 in Yokohama Clinical Oncology Group's department of gastroenterological surgery. Among them, 234 patients with stage II/III disease who had undergone surgical resection of their primary lesions were analyzed, retrospectively. We report the long-term outcomes, the risk factors for recurrence, and the prognostic factors., Results: The five-year disease free survival and cancer-specific survival were 50.6% and 80.3%, respectively. A multivariate analysis showed the ASA-PS (HR = 2.23, P = 0.026), serum Albumin ≤ 4.0 g/dL (HR = 2.96, P = 0.007), T4 tumor (HR = 2.73, P = 0.002) and R1 resection (HR = 6.56, P = 0.02) to be independent risk factors for recurrence. Furthermore, poorly differentiated cancers (HR = 6.28, P = 0.009), a T4 tumor (HR = 3.46, P = 0.011) and R1 resection (HR = 6.16, P = 0.006) were independent prognostic factors in patients with obstructive CRC., Conclusion: The outcomes of patients with obstructive CRC was poor. T4 tumor and R1 resection were found to be independent prognostic factors for both recurrence and survival in patients with obstructive CRC.
- Published
- 2016
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