Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancer

Am J Surg. 2008 Apr;195(4):427-32. doi: 10.1016/j.amjsurg.2007.02.027.


Background: The aim of this observational study was to analyze the differences between patients with obstructive and perforated colonic cancer who managed with emergency curative surgery.

Methods: Between January 1994 and December 2000, patients deemed to have undergone curative resection for complicated colonic cancer were considered for inclusion in the study. They were classified into 2 groups: patients with obstructive cancer (OC) and patients with perforated cancer (PC). The main end points were postsurgical outcomes and long-term overall survival, cancer-related survival, and tumor recurrence.

Results: Of the 236 patients, surgery was deemed to be radical and performed with intent to cure in 155 patients (65.7%): 117 patients in the OC group and 38 patients in the PC group. No statistical differences were observed between the percentage of radical surgery between the 2 groups (P = .63). The overall postsurgical mortality rate was 12.2%: 14 patients in the OC group and 5 patients in the PC group (P = .839). Overall survival, probability of being free of recurrence, and cancer-related survival of the entire series were 64.57%, 67.72% and 73.03%, respectively. There were no differences between the 2 groups with respect to tumor recurrence, type of recurrence, overall survival, probability of being free of recurrence, and cancer-related survival at 5 years.

Conclusions: In our experience, patients with perforated colonic cancer do not seem to show worse long-term outcomes than those with OC. Studies with larger series are needed for further investigations.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy* / methods
  • Colectomy* / mortality
  • Colonic Neoplasms / complications*
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Disease-Free Survival
  • Emergency Treatment
  • Female
  • Humans
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / mortality
  • Intestinal Obstruction / surgery*
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / mortality
  • Intestinal Perforation / surgery*
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm Staging
  • Recurrence
  • Survival Analysis
  • Treatment Outcome