Survival analysis for complicated colorectal cancer

Abstract

Introduction. Emergency surgical interventions for complicated colorectal cancer (CCRC) are characterized by high frequency of postoperative complications and mortality, as well as worse prognosis, compared to planned interventions. The study objective is to evaluate overall survival (OS) and relapse-free survival (RFS) in patients with CCRC who underwent emergency surgery in specialized and general surgical in-patient facilities. Materials and methods. An electronic database (registry) includes data on 1098 patients with urgent complications of colorectal cancer who underwent treatment in general surgical and specialized in-patient facilities in Smolensk in 2001–2013. Depending on the specialty of an in-patient facility, all patients were divided into 3 groups: coloproctological (n = 352), oncological (n = 69), general surgical (n = 677) in-patient facility. Results. The percentage of R1-resections in general surgical in-patient facilities was 22.3 %, examination of 12 or more lymph nodes was performed only in 11.4 % of cases. Patients with CCRC who underwent surgery in general surgical in-patient facilities didn’t receive adjuvant treatment in 55.5 % of observations. OS and RFS were higher in CCRC patient groups who underwent surgery in an oncological dispensary or department of coloproctology compared to general surgical facilities (p <0.0001). The type of surgical intervention significantly affected survival: OS and RFS were higher after multi-stage surgeries with tumor removal at the 2>nd stage compared to other types of surgical interventions (p < 0.0001). Conclusion. Analysis of OS and RFS demonstrates that oncologically adequate surgical interventions are performed in specialized in-patient facilities.

Keywords

• complicated colorectal cancer
• overall survival
• relapse-free survival