The Effect of Primary Tumour Resection on Prognosis in Emergency-operated Liver Metastatic Colon Cancer

Abstract

Introduction:Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths in western societies. It is also the third cause of cancer-related deaths in male and female populations in the world. In population-based studies, 25%- 30% of CRC patients are faced with liver metastasis at some point in their disease. Colon and rectal cancers most frequently metastasise to the liver and lungs. This study, which was carried out in patients who were operated due to acute complications of liver metastatic CRC; aimed to investigate the effects of primary tumour removal on mortality, morbidity, and survival.Methods:Patients with colon or rectal cancer with liver metastases who applied to the University of Health Sciences Turkey, İstanbul Training and Research Hospital Emergency Service between 2011 and 2016 and were urgently operated were included in the study.Results:A total of 59 patients were evaluated. There were 30 (50.8%) male and 29 (49.2%) female patients. The ages of the participants ranged from 24 to 86 years, with a median age of 65 (24-86) years. Primary tumour resection was performed in 37 (62.7%) patients during emergency surgery, whereas resection was not performed in 22 (37.3%) patients. The postoperative survival of the patients is minimum 1 month and maximum 60 months. The files of patients with a survival of more than sixty months were not followed after the 60th month. Twentythree patients never received chemotherapy and thirty-six patients were operated during chemotherapy treatment. The hospitalization period of 44 (74.6%) patients was more than 10 days, and the hospitalization period of 15 (25.4%) patients was 10 days or less. When we take 24 months as a basis for the survival of the patients, the number of patients with 24 months or more survival is 23 (39%) and the number of patients with survival below 24 months is 36 (61%). When the 24-month survival “cut off” value was taken, the independent data of the patients were evaluated individually in terms of prognosis and whether it was significant (p>0.05).Conclusion:Metastatic CRC patients are generally in the advanced age group. Many of these patients also have additional pathologies. Performing primary tumour resection contributes significantly to the average life expectancy in urgently-operated metastatic CRC patients. Still, this is a difficult surgical procedure; the best decision should be made during surgery, with several factors such as the general condition of the patient, additional pathologies, the experience of the surgeon, and whether the tumour is resectable being taken into consideration.

Keywords

• colorectal cancer
• metastasis
• liver
• survey