A Concise Review Evaluating the Safety and Effectiveness of Emergency General Surgery in Cancer Patients

Emergency general surgery (EGS) is frequently required in patients with cancer and is associated with high mortality. However, data describing outcomes in this population remains limited. This concise review aims to synthesize the available evidence on short-term mortality and postoperative complications following EGS in adult cancer patients.

This concise review searched five major databases, including ProQuest, Cochrane, Google Scholar, PubMed, and Embase, to identify studies published from January 2000 through December 2025 evaluating outcomes of EGS in adult cancer patients.

Of 1054 records identified, 23 studies met the inclusion criteria. EGS was associated with high short-term mortality (30-d mortality 18-34%) and complication rates up to 67%. In colorectal cancer, emergency surgery demonstrated higher mortality (3.4-28.6% versus 0.8-10.6%) and longer hospital stay (8.28 versus 6.75 d) compared to elective surgery. There were fewer postoperative complications (26.6% versus 38.4%) and improved 3-y survival following laparoscopic compared with open emergency colorectal resection. Exploratory analyses suggest that worse outcomes were associated with stage IV disease (80.0% versus 53.7%), age ≥ 70 y (14.5% 30-d mortality), and recent systemic therapy (+42% 90-d mortality).

EGS in cancer patients is associated with high mortality and complication rates, particularly when compared with elective or nonoperative management. Outcomes are strongly associated with patient- and disease-related factors, including cancer stage, age, and prior treatment. In select populations, particularly colorectal cancer, minimally invasive approaches may be feasible and associated with improved outcomes.