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 20 February 2018

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News

Emergency versus elective surgeries for complicated colonic cancer

Cancer-related survival for complicated colonic cancer may approach that of elective surgery if treatment is performed according to radical oncologic criteria, whilst curative surgeries are acceptable in emergency conditions, reports the latest American Journal of Surgery.

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A significantly decreased long-term survival has been observed in patients undergoing surgery for complicated colorectal tumors compared with uncomplicated ones.

However, the role of radical oncologic surgery on emergency colonic cancer is not clearly defined.

Dr Biondo and colleagues from Spain analyzed the efficacy of a curative emergency surgery in terms of tumor recurrence and cancer-related survival compared with elective colonic surgery.

The research team included 266 patients with colonic cancer deemed to have undergone a curative resection in a prospective study from 1996 to 1998.

The team classified the patients into 2 groups where the first group (n=59) underwent emergency surgery for complicated colonic cancer, and group 2 (n=207) underwent elective surgery.

The overall survival of stage II tumors does not differ between surgery groups
American Journal of Surgery

The main end points were cancer related survival and the probability of being free from recurrence at 3 years.

The investigative team noted that postoperative mortality was higher in the first group undergoing emergency surgery.

After patients were stratified by the tumor node metastasis system, the researchers did not identify significant differences between the groups with respect to overall survival of stage II tumors.

In addition, the research team did not note significant differences in the probability of being free from recurrence and cancer-related survival of stage III cancers.

The investigators observed differences for the overall survival in stage III tumors, and for the probability of being free from recurrence and cancer-related survival in stage II cancers.

When patients with elective stage II tumors presenting 1 or more negative prognostic factor were compared with emergency patients affected by a stage II colonic cancer, no differences were observed by the team.

Dr Biondo’s team concluded, “Curative surgeries for complicated colonic cancer are acceptable in emergency conditions.”

“Cancer-related survival and recurrence in patients with complicated colonic cancers may approach that of elective surgery if a surgical treatment with radical oncologic criteria is performed.”

Am J Surg 2005: 189(4): 377-383
15 April 2005

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