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Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The purpose of this study was to examine the long-term overall survival (OS) of colon cancer patients who underwent emergent resection versus patients who were resected electively.

Methods

The 2006–2012 National Cancer Data Base was queried for colon cancer patients who underwent surgical resection. Emergent resection was defined as resection within 24 h of diagnosis. A mixed-effects logistic regression was used to estimate the effect of emergent resection on 30- and 90-day mortality. A propensity score-matched mixed-effects Cox proportional-hazards model was used to estimate the effect of emergent resection on 5-year OS.

Results

Two hundred fourteen thousand one hundred seventy-four patients met inclusion criteria, 30% of the cohort had an emergent resection. After controlling for patient and hospital factors, pathological stage, lymph node yield, margin status, and adjuvant chemotherapy, emergent resection was associated with increased odds of 30-day mortality (OR = 1.69, 95% CI = 1.60, 1.78) and hazard of death at 5 years (HR = 1.13, 95% CI = 1.09, 1.15) compared to elective resections.

Conclusion

Emergent resection for colon cancer is independently associated with poor short-term outcomes and decreased 5-year OS compared to elective resection. With 30% of cases in this study emergent, these findings underlie the importance of adherence to colon cancer screening guidelines to limit the need for emergent resections.

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Author Contributions

Concept and Design: Xu, Arsalanizadeh, Becerra, Aquina, Hensley, Swanger, Noyes, Monson, Fleming

Acquisition of Data: Xu, Becerra, Fleming

Analysis and Interpretation of Data: Xu, Becerra, Fleming

Drafting of Article: Xu

Critical Revision: Becerrra, Aquina, Hensley, Justiniano, Boodry, Swanger, Arsalanizadeh, Noyes, Monson, Fleming

Final Approval: Xu, Becerra, Aquina, Hensley, Justiniano, Boodry, Swanger, Arsalanizadeh, Noyes, Monson, Fleming

Financial Support

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Authors and Affiliations

  1. Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue Box SURG, Rochester, NY, 14642, USA

    Zhaomin Xu, Christopher T. Aquina, Bradley J. Hensley, Carla F. Justiniano, Courtney Boodry, Alex A. Swanger, Reza Arsalanizadeh & Fergal J. Fleming

  2. Department of Public Health Sciences, Division of Epidemiology, University of Rochester Medical Center, Rochester, NY, USA

    Adan Z. Becerra

  3. Department of Epidemiology and Environmental Health, Division of Health Services Policy and Practice, State University of New York at Buffalo, School of Public Health and Health Professions, Buffalo, NY, USA

    Katia Noyes

  4. Center for Colon and Rectal Surgery, Florida Hospital Medical Group, University of Central Florida, College of Medicine, Orlando, FL, USA

    John R. Monson

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  1. Zhaomin Xu
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Correspondence to Zhaomin Xu.

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Xu, Z., Becerra, A.Z., Aquina, C.T. et al. Emergent Colectomy Is Independently Associated with Decreased Long-Term Overall Survival in Colon Cancer Patients. J Gastrointest Surg 21, 543–553 (2017). https://doi.org/10.1007/s11605-017-3355-8

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  • DOI: https://doi.org/10.1007/s11605-017-3355-8

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