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©The Author(s) 2016.
World J Gastroenterol. Jun 14, 2016; 22(22): 5237-5245
Published online Jun 14, 2016. doi: 10.3748/wjg.v22.i22.5237
Published online Jun 14, 2016. doi: 10.3748/wjg.v22.i22.5237
Table 1 Clinicopathological characteristic of patients with obstructive colorectal cancer n (%)
Variable | Category | n = 234 |
Gender | Male | 141(60.3) |
Female | 93 (39.7) | |
Age (yr)1 | 71 (35-96) | |
ASA | I | 70 (30) |
II | 128 (54.7) | |
III | 36 (15.3) | |
Location of tumor | Cecum | 10 (4.3) |
Ascending colon | 33 (14.1) | |
Transverse colon | 33 (14.1) | |
Descending colon | 36 (15.4) | |
Sigmoid colon | 95 (40.6) | |
Rectum | 15 (10.5) | |
Decompression | + | 183 (78.2) |
- | 51 (21.8) | |
CEA (mg/dL) 1 | 4.9 (0.3-2470) | |
Serum albumin1 | 3.4 (1.4-4.9) | |
Tumor size(mm) | 48 (10-140) | |
Depth of tumor | pT3 | 109 (46.6) |
pT4a | 93 (39.7) | |
pT4b | 32 (13.7) | |
Lymph node involvement | N0 | 113 (48.3) |
N1 | 90 (38.5) | |
N2 | 31 (13.2) | |
R0 resection | + | 219 (93.6) |
- | 15 (6.4) | |
Adjuvant chemotherapy | + | 91 (38.9) |
- | 143 (61.1) |
Table 2 Patterns of recurrence following colorectal resection of obstructive colorectal cancer (n = 71)
Site of recurrence | n (%) |
Liver | 27 (11.5) |
Lung | 22 (9.4) |
Peritoneal dissemination | 21 (9.0) |
Local recurrence | 9 (3.8) |
Lymph node | 6 (2.6) |
Anastomosis | 3 (1.3) |
Abdominal wall | 2 (0.9) |
Pleural dissemination | 2 (0.9) |
Table 3 Result of the univariate and multivariate analysis of risk factors for recurrence
Factor | n | Univariate analysis | Multivariate analysis | ||||
3-yr RFS | 5-yr RFS | P value | HR (95%CI) | P value | |||
Gender | M | 141 | 59.2% | 47.6% | 0.409 | ||
F | 93 | 66.8% | 54.7% | ||||
Age (yr) | ≥ 75 | 96 | 55.0% | 42.4% | 0.011 | 1.228 (0.659-2.290) | 0.518 |
< 75 | 138 | 67.3% | 55.9% | ||||
ASA-PS | 1 | 71 | 75.7% | 64.8% | 0.017 | 2.234 (1.101-4.535) | 0.026 |
2-3 | 163 | 56.6% | 44.6% | ||||
BMI (kg/m2) | ≥ 25 | 28 | 66.0% | 49.7% | 0.951 | ||
< 25 | 193 | 62.7% | 52.7% | ||||
Serum albumin (g/dL) | ≤ 4.0 | 172 | 54.9% | 41.3% | 0.001 | 2.967 (1.342-6.560) | 0.007 |
> 4.0 | 48 | 79.7% | 73.1% | ||||
CEA (mg/dL) | ≥ 5.0 | 102 | 52.4% | 44.8% | 0.052 | ||
< 5.0 | 113 | 74.1% | 54.2% | ||||
Decompression | + | 183 | 62.9% | 50.7% | 0.572 | ||
- | 51 | 60.5% | 50.4% | ||||
Location of tumor | Right side | 69 | 62.5% | 55.5% | 0.738 | ||
Left side | 165 | 62.1% | 48.7% | ||||
Tumor size (mm) | ≥ 50 | 99 | 61.0% | 48.8% | 0.384 | ||
< 50 | 121 | 63.9% | 54.1% | ||||
Differentiation of tumor | tub1,tub2 | 222 | 63.7% | 51.2% | 0.080 | ||
por, muc | 12 | 36.7% | 36.7% | ||||
Depth of tumor | T3 | 108 | 73.5% | 64.7% | 0.001 | 2.728 (1.467-5.072) | 0.002 |
T4 | 126 | 53.0% | 38.7% | ||||
Intramural lymphatic invasion | + | 157 | 61.4% | 53.2% | 0.600 | ||
- | 73 | 64.4% | 45.2% | ||||
Intramural vascular invasion | + | 164 | 60.3% | 49.3% | 0.683 | ||
- | 70 | 68.1% | 57.4% | ||||
Lymph node involvement | + | 120 | 65.7% | 47.4% | 0.856 | ||
- | 114 | 59.1% | 53.2% | ||||
Lymph node dissection | D0,D1 | 31 | 44.3% | 44.3% | 0.067 | ||
D2,D3 | 199 | 64.7% | 50.8% | ||||
No. of lymph nodes harvested | < 12 | 73 | 54.8% | 44.5% | 0.085 | ||
≥ 12 | 151 | 66.4% | 52.5% | ||||
Postoperative complication | + | 78 | 57.3% | 44.7% | 0.071 | ||
(≥ Grade 2) | - | 156 | 64.7% | 53.5% | |||
Anastomotic leakage | + | 18 | 71.1% | 56.9% | 0.562 | ||
- | 191 | 61.7% | 50.0% | ||||
Curability | R0 | 219 | 66.4% | 54.8% | < 0.001 | 6.555 (1.344-31.970) | 0.020 |
R1 | 15 | 7.6% | 0.0% | ||||
Adjuvant chemotherapy | + | 91 | 66.2% | 55.6% | 0.069 | ||
- | 143 | 59.8% | 47.2% |
Table 4 Result of the univariate and multivariate analysis of prognostic factors for cancer-specific survival
Factor | n | Univariate analysis | Multivariate analysis | ||||
3-yr CSS | 5-yr CSS | P value | HR(95%CI) | P value | |||
Gender | M | 141 | 88.3% | 80.8% | 0.924 | ||
F | 93 | 87.8% | 79.7% | ||||
Age (yr) | ≥ 75 | 96 | 82.2% | 71.6% | 0.027 | 1.464 (0.647-3.310) | 0.360 |
< 75 | 138 | 91.9% | 85.4% | ||||
ASA-PS | 1 | 71 | 86.0% | 83.5% | 0.710 | ||
2-3 | 163 | 89.0% | 78.7% | ||||
BMI (kg/m2) | ≥ 25 | 28 | 92.0% | 85.8% | 0.389 | ||
< 25 | 193 | 87.3% | 80.0% | ||||
Serum albumin (g/dL) | ≤ 4.0 | 172 | 85.6% | 82.6% | 0.536 | ||
> 4.0 | 48 | 87.7% | 76.2% | ||||
CEA (mg/dL) | ≥ 5.0 | 102 | 86.7% | 80.0% | 0.715 | ||
< 5.0 | 113 | 90.5% | 82.0% | ||||
Decompression | + | 183 | 88.4% | 81.7% | 0.514 | ||
- | 51 | 87.1% | 74.8% | ||||
Location of tumor | Right side | 69 | 82.6% | 70.5% | 0.103 | ||
Left side | 165 | 90.4% | 84.3% | ||||
Tumor size (mm) | ≥ 50 | 99 | 84.1% | 76.9% | 0.291 | ||
< 50 | 121 | 90.4% | 85% | ||||
Differentiation of tumor | tub1, tub2 | 222 | 89.9% | 82.5% | 0.001 | 6.282 (1.584-24.909) | 0.009 |
por, muc | 12 | 50.0% | 50.0% | ||||
Depth of tumor | T3 | 108 | 95.7% | 92.3% | 0.001 | 3.458 (1.324-9.031) | 0.011 |
T4 | 126 | 81.1% | 69.2% | ||||
Intramural lymphatic invasion | + | 157 | 90.8% | 82.7% | 0.449 | ||
- | 73 | 86.9% | 79.4% | ||||
Intramural vascular invasion | + | 164 | 94.2% | 90.1% | 0.152 | ||
- | 70 | 85.9% | 76.7% | ||||
Lymph node involvement | + | 120 | 92.5% | 82.9% | 0.332 | ||
- | 114 | 84.0% | 77.7% | ||||
Lymph node dissection | D0, D1 | 31 | 60.7% | 60.7% | 0.014 | 0.958 (0.300-3.056) | 0.942 |
D2, D3 | 199 | 90.4% | 83.0% | ||||
No. of lymph nodes harvested | < 12 | 73 | 83.3% | 78.3% | 0.314 | ||
≥ 12 | 151 | 91.1% | 81.0% | ||||
Postoperative complication | + | 78 | 85.9% | 75.6% | 0.644 | ||
(≥ Grade 2) | - | 156 | 89% | 82.5% | |||
Anastomotic leakage | + | 18 | 100% | 100% | 0.069 | ||
- | 191 | 87.1% | 78.7% | ||||
Curability | R0 | 219 | 91.3% | 84.7% | < 0.001 | 6.162 (1.692-22.445) | 0.006 |
R1 | 15 | 39.7% | 19.9% | ||||
Adjuvant chemotherapy | + | 91 | 87.7% | 81.8% | 0.800 | ||
- | 143 | 88.8% | 79.4% |
- Citation: Atsushi I, Mitsuyoshi O, Kazuya Y, Syuhei K, Noriyuki K, Masashi M, Akira W, Kentaro S, Nobuyuki K, Natsuko S, Jun W, Yasushi I, Chikara K, Itaru E. Long-term outcomes and prognostic factors of patients with obstructive colorectal cancer: A multicenter retrospective cohort study. World J Gastroenterol 2016; 22(22): 5237-5245
- URL: https://www.wjgnet.com/1007-9327/full/v22/i22/5237.htm
- DOI: https://dx.doi.org/10.3748/wjg.v22.i22.5237