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Carcinoma of the caecum
C P Armstrong1, Z Ahsan, G Hinchley
1Derriford Hospital, Plymouth, Devon, UK.
Journal of the Royal College of Surgeons of Edinburgh
|April 1, 1990
Summary
Early diagnosis and perioperative care are crucial for improving outcomes in elderly patients with right colon cancer. This review highlights advanced tumor stages at presentation and the benefits of surgical resection, even in complex cases.
Area of Science:
- Oncology
- Gastroenterology
- Epidemiology
Background:
- Carcinoma of the caecum (right colon cancer) often presents in elderly patients with advanced disease.
- A significant proportion of cases are diagnosed during emergencies or found incidentally.
- Synchronous tumors are a notable comorbidity in a quarter of patients.
Purpose of the Study:
- To review the management and outcomes of patients with carcinoma of the caecum.
- To identify factors influencing survival and identify areas for improved patient care.
- To analyze presentation, treatment, and survival rates over an 11-year period.
Main Methods:
- Retrospective review of 519 unselected patients with caecal carcinoma.
- Data collection on patient demographics, presentation, surgical intervention, and outcomes.
- Analysis of survival rates, morbidity, and mortality associated with resection.
Main Results:
- Median patient age was 76 years, with a trend towards increasing age.
- One-third of patients presented as emergencies, often with bowel obstruction.
- Tumors were frequently advanced at diagnosis (5% Dukes' A), yet resection was widely performed with low morbidity and 2.6% mortality.
- Age-adjusted 5-year survival was 37%, increasing to 64% for 'curative' resections.
Conclusions:
- Early referral and diagnosis are key to improving right colon cancer management.
- Aggressive surgical management, even in elderly patients with advanced disease, can yield positive outcomes.
- Optimized perioperative care is essential for this aging patient population.