Colorectal Oncologic Emergencies: Recognition, Management, and Outcomes

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Colorectal cancer is a leading malignancy in the US with a declining age of diagnosis.
• Screening aims for prevention and early detection, yet oncologic emergencies still occur.
• Approximately 15% of colorectal cancer patients present with surgical emergencies, primarily obstruction or perforation.

Purpose of the Study:

• To highlight the challenges associated with colorectal cancer presenting as oncologic emergencies.
• To characterize the patient cohort experiencing colorectal cancer emergencies.
• To identify common emergency presentations and associated advanced disease features.

Main Methods:

• Retrospective analysis of colorectal cancer cases presenting as surgical emergencies.
• Review of patient demographics, clinical presentation, and pathological findings.
• Comparison of emergency presentation cohort with non-emergency colorectal cancer cases.

Main Results:

• Colorectal cancer emergencies constitute a significant subset of cases (15%).
• Common emergency presentations include colonic perforation and obstruction.
• Patients with colorectal cancer emergencies often exhibit advanced disease, including increased T stage, lymphovascular invasion, and liver metastases.

Conclusions:

• Colorectal cancer emergencies represent a critical clinical challenge.
• Prompt recognition and management are crucial for this patient group.
• Advanced disease characteristics are prevalent in patients presenting with colorectal cancer emergencies.