Aim To evaluate retrospectively demographic, clinical and histopathological variables effective on mortality in patients who had undergone emergency surgery due to complicated colorectal cancer. Methods A total of 39 patients underwent urgent surgical interventions due to complicated colorectal cancer at the Department of General Surgery, Dursun Odabaş Medical Center, between January 2010 and January 2015. Thirty three of these were included in the study. Six patients were excluded because complete medical records had been missing. Medical records of the 33 cases were retrospectively reviewed. Results There were 14 (42.5%) male and 19 (57.5%) female patients. Mean age was 60 years (range: 32- 83 years); 14 (42.5%) patients were less than 60 years old , while 19 (57.5%) were 60 years old or older. Operations were performed due to perforation (39.3%) and obstruction (60.6%) in 13 and 20 patients, respectively. Tumor localization was in the right and transverse colon in nine (21.2%) and in the left colon in 24 cases (72.7%). Eleven (33.3%) patients underwent resection and anastomosis, 13 (39.3%) resection and ostomy, and nine (27.2%) patients underwent ostomy alone without any resection. Postoperative mortality occurred in nine cases (27.2%). Conclusions High mortality should be expected in females older than 60 years with a left sided colon tumor or with another synchronous tumor and in perforated tumors. Unnecessary major resections should be avoided and primary pathology should be in the focus of treatment in order to decrease the mortality and morbidity rates.
Quinten C, Martinelli F, Coens C, Sprangers M, Ringash J, Gotay C, et al. Patient Reported Outcomes and Behavioral Evidence (PRO-BE) and the European Organization for Research and Treatment of Cancer (EORTC) Clinical Groups. A global analysis of multi-trial data investigating quality of life and symptoms as prognostic factors for survival in different tumor sites. Cancer. 2013. p. 302–11.
2.
Anantha R, Brackstone M, Parry N, Leslie. An acute care surgery service expedites the treatment of emergency colorectal cancer: a retrospective casecontrol study. World J Emerg Surg. 2014. p. 19.
3.
Hreinsson J, Jonasson J, Bjornsson E. Bleeding related symptoms in colorectal cancer: a 4-year nationwide population-based study. Aliment Pharmacol Ther. 2014. p. 77–84.
4.
Cameron J, Cameron A. Current Surgical Therapy: Expert consult-online. 11th ed. Elsevier Health Sciences; 2014. p. 213.
5.
Rabeneck L, Paszat L, Li C. Risk factors for obstruction, perforation, or emergency admission at presentation in patients with colorectal cancer: a population-based study. Am J Gastroenterol. 2006. p. 1098–103.
6.
Scott N, Jeacock J, Kingston R. Risk factors in patients presenting as an emergency with colorectal cancer. Br J Surg. 1995. p. 321–3.
7.
Lewis M, Hendrickson A, Moynihan T. Oncologic emergencies: pathophysiology, presentation, diagnosis, and treatment. CA Cancer J Clin. 2011. p. 287–314.
8.
Edge S, Byrd D, Compton C, Fritz A, Greene F, Trotti A. AJCC Cancer Staging Manual. Springer; 2010.
9.
Tentes A, Mirelis C, Kakoliris S, Korakianitis O, Bougioukas I, Tsalkidou E, et al. Results of surgery for colorectal carcinoma with obstruction. Langenbecks Arch Surg. 2009. p. 49–53.
10.
Tan K, Sim R. Surgery for obstructed colorectal malignancy in an Asian population: predictors of morbidity and comparison between left-and rightsided cancers. J Gastrointest Surg. 2010. p. 295–302.
11.
Chen H, Sheen-Chen S. Obstruction and perforation in colorectal adenocarcinoma: an analysis of prognosis and current trends. Surgery. 2000. p. 370–6.
12.
Crucitti F, Sofo L, Doglietto G, Bellantone R, Ratto C, Bossola M, et al. Prognostic factors in colorectal cancer: current status and new trends. J Surg Oncol Suppl. 1991. p. 76–82.
13.
Mado K, Masuda H, Mazaki T, Ishii Y, Aoki N, Ogame H, et al. The proposal of objective evaluation method of treatment level for patients with colorectal perforation. Jpn J Gastroenterol Surg. 2009. p. 1455–9.
14.
Mcardle C, Hole D. Emergency presentation of colorectalcancer is associated with poor 5-year survival. Br J Surg. 2004. p. 605–9.
15.
Wong S, Jalaludin B, Morgan M, Berthelsen A, Morgan A, Gatenby A, et al. Tumor pathology and long-term survival in emergency colorectal cancer. Dis Colon Rectum. 2008. p. 223–30.
16.
Bass G, Fleming C, Conneely J, Martin Z, Mealy K. Emergency first presentation of colorectal cancer predicts significantly poorer outcomes: a review of 356 consecutive Irish patients. Dis Colon Rectum. 2009. p. 678–84.
17.
Betge J, Pollheimer M, Lindtner R, Kornprat P, Schlemmer A, Rehak P, et al. Langner C. Intramural and extramural vascular invasion in colorectal cancer: prognostic significance and quality of pathology reporting. Cancer. 2012. p. 628–38.
18.
Liebig C, Ayala G, Wilks J, Verstovsek G, Liu H, Agarwal N, et al. Perineural invasion is an independent predictor of outcome in colorectal cancer. J Clin Oncol. 2009. p. 5131–7.
19.
Goodyear S, Leung E, Menon A, Pedamallu S, Williams N, Wong L. The effects of population based faecal occult blood test screening upon emergency colorectal cancer admissions in Coventry and north Warwickshire. Gut. 2008. p. 218–22.
20.
Hwang H. Emergency presentation of colorectal cancer at a regional hospital: an alarming trend? Br Columbia Med J. 2012. p. 83–7.
21.
Mayor. One in four cases of bowel cancer in England are diagnosed only after emergency admission. BMJ. 2012. p. 7117.
22.
Gulliford M, Sedgwick J, Pearce A. Cigarette smoking, health status, socio-economic status and access to health care in diabetes mellitus: a crosssectional survey. BMC Health Serv Res. 2003. p. 4.
23.
Huckle T, You R, Casswell S. Socio-economic status predicts drinking patterns but not alcohol-related consequences independently. Addiction. 2010. p. 1192–202.
24.
Stewart D, Adams C, Cano M, Correa-Fernández V, Li Y, Waters A, et al. Associations between health literacy and established predictors of smoking cessation. Am J Public Health. 2013. p. 43–9.
25.
Pampel F, Krueger P, Denney J. Socioeconomic disparities in health behaviors. Annu Rev Sociol. 2010. p. 349–70.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
