Skip to main content

Advertisement

Log in

Perforated colorectal cancer

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Perforations are rare but serious complications of colorectal cancer, with mortality rates of 30 to 40 percent. The aim of this retrospective study was to investigate possible indicators of prognosis and causes of death and to evaluate the risk of this complication by comparing results in perforated tumors with uncomplicated cancers or largebowel perforations attributable to benign causes. METHODS: Data of postoperative and long-term results of 35 patients with perforated colorectal cancers were compared in 868 patients with uncomplicated cancers and 130 patients with large-bowel perforations attributable to benign diseases. Postoperative survival in perforated cancers (mortality, 40 percent) was determined by degree of peritonitis, septic state, and tumor stages. RESULTS: Comparison of the three groups demonstrated advanced tumor stages, a higher rate of septic organ failures, and higher mortality rates for perforated cancers. Long-term survival depended on tumor stages but did not differ in perforated and uncomplicated cancers. CONCLUSIONS: A cumulative effect of malignancy and sepsis may be responsible for the high postoperative mortality in malignant perforation. Patients with perforated cancers represent the highest risk group in colonic perforation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Miller LD, Boruchow IB, Fitts WT Jr. An analysis of 284 patients with perforative carcinoma of the colon. Surg Gynecol Obstet 1966;123:1212–8.

    CAS  PubMed  Google Scholar 

  2. Crowder VH Jr, Cohn I Jr. Perforation in cancer of the colon and rectum. Dis Colon Rectum 1967;10:415–20.

    PubMed  Google Scholar 

  3. Glenn F, McSherry CK. Obstruction and perforation in colorectal cancer. Ann Surg 1971;173:983–92.

    CAS  PubMed  Google Scholar 

  4. Welch JP, Donaldson GA. Perforative carcinoma of colon and rectum. Ann Surg 1974;180:734–40.

    CAS  PubMed  Google Scholar 

  5. Peloquin A-B. Factors influencing survival with complete obstruction and free perforation of colorectal cancers. Dis Colon Rectum 1975;18:11–21.

    CAS  PubMed  Google Scholar 

  6. Kelley WE Jr, Brown PW, Lawrence W Jr, Terz JJ. Penetrating, obstructing, and perforating carcinomas of the colon and rectum. Arch Surg 1981;116:381–4.

    PubMed  Google Scholar 

  7. Hermanek PJ Jr, Schweiger M, Gall FP. Colorectal carcinoma presenting in emergency situation. Langenbecks Arch Chir 1985;366:461–5.

    PubMed  Google Scholar 

  8. Kyllönen LE. Obstruction and perforation complicating colorectal carcinoma. Acta Chir Scand 1987;153:607–14.

    PubMed  Google Scholar 

  9. Runkel NS, Schlag P, Schwarz V, Herfarth C. Outcome after emergency surgery for cancer of the large intestine. Br J Surg 1991;78:183–8.

    CAS  PubMed  Google Scholar 

  10. Billing A, Fröhlich D. Therapeutic aspects of large bowel perforation due to carcinoma. Akt Chir 1992;27:226–9.

    Google Scholar 

  11. International Union Against Cancer (UICC). Colon, rectum. In: Harmer MH, ed. TNM classification of malignant tumors. Geneva: UICC, 1978:69–76.

    Google Scholar 

  12. Bone R, Fisher C, Clemmer T, Slotman G, Metz C, Balk R. Sepsis syndrome: a valid clinical entity. Crit Care Med 1989;17:389–93.

    Article  CAS  PubMed  Google Scholar 

  13. Linder M, Wacha H, Feldmann U, Wesch G, Grundlach E, Streifensand R. The Mannheimer Peritonitis Index. Chirurg 1987;58:84–92.

    CAS  PubMed  Google Scholar 

  14. Kriwanek S, Armbruster C, Beckerhinn P, Dittrich K. Prognostic factors for survival in colonic perforation. Int J Colorectal Dis 1994;9:158–162.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Read at the meeting of the Austrian Society for Surgical Oncology, Pörtschach, Austria, September 21 to 23, 1995.

About this article

Cite this article

Kriwanek, S., Armbruster, C., Dittrich, K. et al. Perforated colorectal cancer. Dis Colon Rectum 39, 1409–1414 (1996). https://doi.org/10.1007/BF02054530

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02054530

Key words

Navigation