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Outcomes in Patients with Obstructive Jaundice from Metastatic Colorectal Cancer and Implications for Management

Journal of Gastrointestinal Surgery volume 18, pages 2186–2191 (2014)Cite this article

Abstract

Introduction

Patients with metastatic colorectal cancer can develop jaundice from intrahepatic or extrahepatic causes. Currently, there is little data on the underlying causes and overall survival after onset of jaundice. The purpose of this study was to characterize the causes of jaundice and determine outcomes.

Methods

Six hundred twenty-nine patients treated for metastatic colorectal cancer between 2004 and 2010 were retrospectively reviewed. Those developing jaundice were grouped as having intrahepatic or extrahepatic obstruction. Demographics, clinicopathologic, and outcome data were analyzed.

Results

Sixty-two patients with metastatic colorectal cancer developed jaundice. Intrahepatic biliary obstruction was most common, occurring in younger patients. Time from metastatic diagnosis to presentation of jaundice was similar between groups, as was the mean number of prior lines of chemotherapy. Biliary decompression was successful 41.7 % of the time and was attempted more commonly for extrahepatic causes. Median overall survival after onset of jaundice was 1.5 months and it was similar between groups, but improved to 9.6 months in patients who were able to receive further chemotherapy.

Conclusions

Jaundice due to metastatic colorectal cancer is an ominous finding, representing aggressive tumor biology or exhaustion of therapies. Biliary decompression is often difficult and should only be pursued when additional treatment options are available.

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Funding

No grant or funding was used during this study.

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Authors and Affiliations

  1. Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 410 West 10th Ave, N924 Doan Hall, Columbus, OH, 43210, USA

    Shawnn D. Nichols, Lawrence Shirley, Carl Schmidt, Sherif Abdel-Misih & Mark Bloomston

  2. Division of Surgical Oncology, Upstate Medical University, State University of New York, Syracuse, NY, USA

    Scott Albert

  3. Department of Gastroenterology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Samer El-Dika & J. Royce Groce

  4. Division of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Christina Wu, Richard M. Goldberg & Tanios Bekaii-Saab

Authors
  1. Shawnn D. Nichols
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  2. Scott Albert
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  3. Lawrence Shirley
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  4. Carl Schmidt
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  5. Sherif Abdel-Misih
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  6. Samer El-Dika
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  7. J. Royce Groce
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  8. Christina Wu
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  9. Richard M. Goldberg
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  10. Tanios Bekaii-Saab
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  11. Mark Bloomston
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Correspondence to Mark Bloomston.

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Nichols, S.D., Albert, S., Shirley, L. et al. Outcomes in Patients with Obstructive Jaundice from Metastatic Colorectal Cancer and Implications for Management. J Gastrointest Surg 18, 2186–2191 (2014). https://doi.org/10.1007/s11605-014-2670-6

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  • DOI: https://doi.org/10.1007/s11605-014-2670-6

Keywords

  • Metastatic colorectal cancer
  • Hepatic metastasis
  • Biliary obstruction
  • Jaundice
  • Hyperbilirubinemia