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The survival rate and prognostic factors in 26 perforated colorectal cancer patients

International Journal of Colorectal Disease volume 22, pages 467–473 (2007)Cite this article

Abstract

Purpose

The treatment for perforated colorectal cancer is not easy and the prognosis for this disease is not so predictable. There are some controversies about performing radical operations because colorectal cancer perforation was considered as an advanced stage disease due to the possibility of tumor cell dissemination through the perforation site.

Methods

We selected and enrolled 26 patients with perforated colorectal cancers among the 1,227 patients who underwent operation for colorectal cancer. These cases were retrospectively analyzed by using their medical records and clinicopathological data.

Results

Twenty-eight cases (2.3%) with perforated colorectal cancers were studied and the overall operative mortality rate was 11%. The overall 5-year survival rate was 57.8% when excluding the operative mortality. The overall 5-year cancer-free survival rate was 52.8%. There were significant differences in the survival rate and the cancer-free survival rate between the stages (p=0.008 and p<0.001, respectively). A univariate analysis of the prognostic factors revealed that the number of the metastatic lymph nodes (p=0.018) and the perforation proximal to the cancer (p=0.005) were significantly correlated to worse survival, and the higher number of the metastatic lymph nodes was correlated to a poorer cancer-free survival rate (p<0.001).

Conclusion

For the perforated colorectal cancers, the stage, the perforation proximal to the cancer, and the number of the metastatic lymph nodes were correlated, with the survival and the cancer-free survival as factors of a poor prognosis. The surgical approach selected for perforated colorectal cancer should be in line with the principles of an appropriate cancer operation because the clinical pathway of perforated colorectal cancer is similar to that of uncomplicated colorectal cancer.

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Affiliations

  1. Department of Surgery, St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #62 Youido-dong, Yeongdeungpo-gu, Seoul, 150-713, South Korea

    In Kyu Lee, Hae Myung Jeon & Suk Kyun Chang

  2. Division of Cancer Control and Epidemiology, National Cancer Center Research Institute, Seoul, South Korea

    Na Young Sung

  3. Department of Surgery, Our Lady of Mercy Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Yoon Suk Lee

  4. Department of Surgery, Kangnam St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Sang Chul Lee, Won Kyung Kang & Seong Taek Oh

  5. Department of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Hyeon Min Cho & Jun-Gi Kim

  6. Department of Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Chang Hyeok Ahn

  7. Department of Surgery, Holy Family Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Do Sang Lee

Authors
  1. In Kyu Lee
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  2. Na Young Sung
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  3. Yoon Suk Lee
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  4. Sang Chul Lee
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  5. Won Kyung Kang
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  6. Hyeon Min Cho
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  7. Chang Hyeok Ahn
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  8. Do Sang Lee
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  9. Seong Taek Oh
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  10. Jun-Gi Kim
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  11. Hae Myung Jeon
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  12. Suk Kyun Chang
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Correspondence to In Kyu Lee or Suk Kyun Chang.

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Lee, I.K., Sung, N.Y., Lee, Y.S. et al. The survival rate and prognostic factors in 26 perforated colorectal cancer patients. Int J Colorectal Dis 22, 467–473 (2007). https://doi.org/10.1007/s00384-006-0184-8

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  • DOI: https://doi.org/10.1007/s00384-006-0184-8

Keywords

  • Colorectal neoplasms
  • Intestinal perforation
  • Survival rate