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International Journal of Colorectal Disease

, Volume 33, Issue 11, pp 1525–1532 | Cite as

Long-term oncological outcomes following emergency resection of colon cancer

  • Kerollos Nashat Wanis
  • Michael Ott
  • Julie Ann M. Van Koughnett
  • Patrick Colquhoun
  • Muriel Brackstone
Original Article
  • 84 Downloads

Abstract

Purpose

The relationship between emergency colon cancer resection and long-term oncological outcomes is not well understood. Our objective was to characterize the impact of emergency resection for colon cancer on disease-free and overall patient survival.

Methods

Data on patients undergoing resection for colon cancer from 2006 to 2015 were collected from a prospectively maintained clinical and administrative database. The median follow-up time was 4.4 years. Cox proportional hazards models were used to estimate the hazard ratios for recurrence and death for patients treated with surgery for an emergent presentation. Differences in initiation of, and timeliness of, adjuvant chemotherapy between emergently and electively treated patients were also examined.

Results

Of the 1180 patients who underwent resection for stages I, II, or III colon cancer, 158 (13%) had emergent surgery. After adjustment for patient, tumor, and treatment characteristics, the HR for recurrence was 1.64 (95% CI 1.12–2.40) and for death was 1.47 (95% CI 1.10–1.97). After adjustment for tumor characteristics, patients who underwent emergency resection were similarly likely to receive adjuvant chemotherapy (OR 1.1; 95% CI 0.70–1.76). The time from surgery to initiation of adjuvant chemotherapy was also similar between the groups.

Conclusions

Emergency surgery for localized or regional colon cancer is associated with a greater risk of recurrence and death. This association does not appear to be due to differences in adjuvant treatment. A focus on screening and colon cancer awareness in order to reduce emergency presentations is warranted.

Keywords

Colon cancer Emergency surgery Recurrence Survival 

Notes

Compliance with ethical standards

The database was designed for administrative and research purposes with approval of the Western University Research Ethics Board (REB), and this specific study was also approved.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Kerollos Nashat Wanis
    • 1
  • Michael Ott
    • 1
  • Julie Ann M. Van Koughnett
    • 1
  • Patrick Colquhoun
    • 1
  • Muriel Brackstone
    • 1
  1. 1.Department of SurgeryWestern University, London Health Sciences CentreLondonCanada

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