The team determined the factors affecting survival following palliative large bowel resection for colorectal adenocarcinoma.
They reported their findings in the January issue of Colorectal Disease.
Patients who had a palliative resection of a colorectal cancer, from 1980 to 1993 inclusive, at a single institution, were identified from the Colorectal Cancer Database.
Survival curves were constructed using the Kaplan-Meier method.
Criteria studied were sex, age at operation, site of tumor, T, N, and M status, tumor differentiation, involvement of tumor margins, tumor fixity, and the presence or absence of peritoneal, liver, or distant metastases.
A total of 377 patients (232 men, median age 64 years) fitted the criteria of the study.
Operative mortality was found to be 6%.
|Factors affecting survival after resection:|
- Liver and distant metastases
- T and nodal status
| Colorectal Disease |
Crude 6-month survival rate was 71% and median survival 10.5 months.
Significant factors affecting survival on univariate analysis were, age (< 75 vs > 75 years), T status (T1/T2 vs T3/T4), nodal status (N0 vs N1/N2), distant metastases or liver metastases, tumor differentiation (poor vs moderate/well differentiated), and involved tumor margins.
Multivariate analysis found the following factors significant: age, liver metastases, distant metastases, T status, nodal status, tumor differentiation, and involvement of tumor margins.
G. J. C. Harris and colleagues from the Cleveland Clinic Foundation, comment that the data suggests that palliative resection of advanced colorectal carcinoma should be considered carefully in patients with advanced age, where distant metastases are present, and in cases when primary tumors can not be completely resected.
For the remaining patients, palliative resection may be accomplished with acceptable operative mortality and postoperative survival, they conclude.