Emergency resections in patients with complicated rightand left-sided colon cancer: long-term outcomes

Abstract

Objective: to evaluate five-year overall and relapse-free survival in patients with complicated rightand left-sided colon cancer that underwent emergency resection.Materials and methods. The study included 501 patients with urgent complications of rightand left-sided colon cancer that underwent emergency resection. The data was obtained from an electronic register containing the information on patients with urgent complications of colorectal cancer treated in general and specialized surgical hospitals in Smolensk between 2001 and 2013 (13 years). We assessed fiveyear overall and relapse-free survival in these patients.Results. A total of 501 resections were performed during the study period. We observed significant differences in resection statuses of patients after emergency resection: the R1 resection status was more frequent in individuals with right-sided colon cancer compared to those with left-sided colon cancer (20.8 % vs. 6.9 %, p = 0.0002). Mean number of lymph nodes examined was 4.6 ± 2.0 in patients with right-sided cancer and 5.3 ± 3.0 in patients with left-sided cancer (p = 0.18). There were no differences in the number of patients receiving adjuvant treatment between the groups (p = 0.11). Patients with left-sided stage II/IIIB/IIIС complicated colon cancer demonstrated better overall and relapse-free survival than those with right-sided tumors of the same stages (overall survival: p = 0.007, p = 0.0002, p = 0.0001 for stages II, IIIB, IIIС respectively; relapse-free survival: p = 0.005, p = 0.0003, p = 0.0002 for stages II, IIIB, IIIС respectively).Conclusion. The observed differences in the outcomes of treatment for rightand left-sided complicated colon cancer can be explained by the fact that the majority of emergency resections for right-sided tumors were one-stage and were performed in general surgery hospitals. Patients with left-sided cancer underwent tumor removal on the second stage more often than those with right-sided cancer (32 % vs. 13 %). Treatment of patients with complicated colon cancer should be consistent, stepwise, and pathogenetically reasonable.

Keywords

• emergency resection
• complicated rightand left-sided colon cancer