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Obstructing colorectal carcinomas. Prospective study.

J C Garcia-Valdecasas1, J M Llovera, A M deLacy

  • 1Department of Surgery, Hospital Clinic of Barcelona, University of Barcelona, Spain.

Diseases of the Colon and Rectum
|September 1, 1991
PubMed
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Colorectal cancer causing intestinal obstruction often presents with advanced tumors. Tumor stage, not obstruction itself, is the key predictor of outcomes in patients undergoing surgery.

Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Intestinal obstruction from colonic carcinoma is a common cause of acute abdominal pain.
  • Patient outcomes can vary significantly based on surgical approach and tumor characteristics.

Purpose of the Study:

  • To identify prognostic factors influencing outcomes in patients with colonic carcinoma presenting with intestinal obstruction (OG) versus elective surgery (EG).
  • To compare curative resection rates, morbidity, mortality, and tumor staging between OG and EG groups.

Main Methods:

  • Prospective study including 188 patients with colorectal cancer from September 1984 to March 1988.
  • Comparison of outcomes between 53 patients with obstruction (OG) and 135 patients undergoing elective surgery (EG).

Related Experiment Videos

  • Multivariate analysis using a proportional hazards model to determine independent prognostic factors.
  • Main Results:

    • Curative resection rates were significantly higher in the elective group (EG) (P = 0.029).
    • Tumor staging was significantly more advanced in the obstruction group (OG) (P = 0.026).
    • Multivariate analysis identified tumor staging as the sole independent prognostic factor, overshadowing obstruction status.

    Conclusions:

    • Obstructing colon carcinomas are frequently more locally advanced.
    • Advanced tumor stage, rather than the obstruction itself, is the primary determinant of a worse long-term prognosis in these patients.