Previous studies have drawn attention to the high postoperative mortality and poor survival of patients who present as an emergency with colon cancer.
However, these patients are a heterogeneous group.
Dr McArdle and colleagues established the differences in postoperative mortality.
The investigative team also assessed 5-year survival between patients presenting as an emergency with evidence of blood loss, obstruction and perforation.
The investigative team included 2068 patients who presented with colon cancer between 1991 and 1994 in Scotland.
|Cancer-specific survival at 5 years was 75% after potentially curative surgery|
|British Journal of Surgery|
The 5-year survival rates and the adjusted hazard ratios were calculated.
The team found that the 30-day postoperative mortality following curative resection was higher in patients who presented with evidence of blood loss.
It was also higher in patients presenting with obstruction or perforation than in elective patients.
The team observed that, following potentially curative surgery, cancer-specific survival at 5 years was 75%.
In those who presented with blood loss, obstruction and perforation, cancer-specific survival was 61%, 52% and 47%, respectively.
The corresponding adjusted hazard ratios for cancer-specific survival, relative to elective patients, was 1.6 for patients presenting with evidence of blood loss.
The investigators noted that in patients presenting with obstruction or perforation, the hazard ratios were 2.2, and 2.9.
Dr McArdle's team concluded, “Compared with patients who undergo elective surgery for colon cancer, those who present as an emergency with evidence of blood loss, obstruction or perforation have higher postoperative mortality rates, and poorer cancer-specific survival.”