Abstract
PURPOSE: This study was designed to identify objective criteria that might help surgeons decide which patients with incurable colon cancer will benefit from palliative surgery and which will not. METHODS: Charts of 68 patients with incurable colon cancer were reviewed. Fifty-seven patients underwent resection, six had a bypass of a nonresectable cancer, and five had no surgery at all. Time to death was the major end point of the study. Minor end points were postoperative morbidity and mortality. Independent variables analyzed were comorbidity, preoperative carcinoembryonic antigen, liver function tests, extent of liver metastases, stage and site of tumor, and tumor cell differentiation. RESULTS: There were six postoperative deaths, and six patients had complications. Mean survival after palliative resection was 10.6 months, after bypass was 3.4 months, and after diagnosis in patients not operated on was 2 months. Patients with >50 percent of their liver replaced by cancer had significantly worse survival than those with <50 percent involvement (mean, 4.2 ± 4 standard deviation (SD) vs. 14.4 ± 10.6 SD;P < 0.003, Wilcoxon's rank-sum test). Tumor differentiation also influenced survival (poor, mean 8.4 ± 8.2 SD; well/moderate, 12.5 ±9.2 SD;P < 0.02). No other variable had a significant effect on survival. CONCLUSION: Resection of primary colon cancer in patients with incurable disease has a relatively high postoperative mortality but is worthwhile as long as hepatic metastases occupy less than 50 percent of liver volume.
Similar content being viewed by others
References
Silverberg E, Boring CC, Squiares TS. Cancer statistics. CA 1990;40:9–26.
Devesa JM, Morales V, Enriquez JM,et al. Colorectal cancer: the bases for a comprehensive follow-up. Dis Colon Rectum 1988;31:636–52.
Joffe J, Gordon PH. Palliative resection for colorectal carcinoma. Dis Colon Rectum 1981;24:355–60.
Makela J, Haukipuro K, Laitinen S,et al. Palliative operations for colorectal cancer. Dis Colon Rectum 1990;33:846–50.
Goslin R, Steele G, Zamcheck N,et al. Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon or rectum. Dis Colon Rectum 1982;25:749–53.
Author information
Authors and Affiliations
About this article
Cite this article
Liu, S.K.M., Church, J.M., Lavery, I.C. et al. Operation in patients with incurable colon cancer—Is it worthwhile?. Dis Colon Rectum 40, 11–14 (1997). https://doi.org/10.1007/BF02055675
Issue Date:
DOI: https://doi.org/10.1007/BF02055675