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Preventable perioperative mortality from colorectal cancer
M J Kerin1, D O'Farrell, R P Waldron
1General Hospital, Castlebar, Co. Mayo, Ireland.
Irish Medical Journal
|January 1, 1993
Summary
Detecting hepatic metastases in colorectal cancer patients significantly increases perioperative mortality risk. Specialized pre-operative assessment for advanced disease can help reduce these risks.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Colorectal cancer (CRC) is a significant global health concern.
- Hepatic metastases are common in advanced CRC and impact treatment decisions.
- Perioperative mortality in CRC patients with metastases requires further investigation.
Purpose of the Study:
- To evaluate the incidence of hepatic metastases in primary colorectal cancer.
- To assess the impact of hepatic metastases on resectability and perioperative outcomes.
- To identify factors contributing to high perioperative mortality in patients with advanced CRC.
Main Methods:
- Retrospective analysis of 271 primary colorectal cancer patients.
- Assessment of hepatic metastases presence and resectability.
- Comparison of perioperative mortality rates based on tumour stage and metastasis presence.
Main Results:
- 26% of patients had detectable hepatic metastases.
- Hepatic metastases were present in 82% of patients with non-resectable tumors.
- Perioperative mortality was significantly higher in Dukes' D tumors (33%) compared to localized tumors (6%).
- Locally advanced disease without obstruction contributed to mortality in Dukes' D patients.
Conclusions:
- Hepatic metastases are associated with increased perioperative mortality in colorectal cancer.
- Early and thorough investigation for local dissemination and liver seeding is crucial.
- Specialized pre-operative assessment may reduce unacceptably high perioperative mortality rates.