Emergency Resection for Colonic Cancer Has an Independent and Unfavorable Effect on Long-Term Oncologic Outcome

Area of Science:

• Oncology
• Surgical Gastroenterology
• Clinical Outcomes Research

Background:

• Outcomes for emergency versus elective colorectal cancer (CRC) resection are debated.
• This study evaluates short- and long-term results of emergency vs. elective CRC surgery.

Purpose of the Study:

• To compare short-term postoperative morbidity and long-term survival between emergency and elective colorectal cancer (CRC) resections.
• To identify independent predictors of survival in CRC patients undergoing surgery.

Main Methods:

• Retrospective cohort study of 225 patients undergoing colonic resection for CRC (2013-2017).
• Comparison of postoperative complications, surgical resection standards, and long-term survival using Kaplan-Meier curves and Cox proportional hazard models.

Main Results:

• Emergency CRC surgery patients were older with higher comorbidity scores (ASA, CCI).
• Emergency operations showed significantly higher rates of major complications, anastomotic leakage, reoperation, and postoperative mortality.
• Overall survival was significantly worse for emergency cases (median 41 months vs. not reached), with emergency surgery being an independent predictor of poor survival.

Conclusions:

• Emergency colorectal cancer (CRC) resections lead to increased postoperative morbidity and mortality.
• Despite similar oncological resection standards, emergency surgery independently predicts worse overall survival in CRC patients.