Surgical treatment and overall survival in patients with right-sided obstructing colon cancer—a nationwide retrospective cohort study

Jeske R.E. Boeding*, Marloes A.G. Elferink, Pieter J. Tanis, Johannes H.W. de Wilt, Paul D. Gobardhan, Cornelis Verhoef, Jennifer M.J. Schreinemakers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
11 Downloads (Pure)

Abstract

Purpose: 

The aim of this study was to compare baseline characteristics, 90-day mortality and overall survival (OS) between patients with obstructing and non-obstructing right-sided colon cancer at a national level. 

Methods: 

All patients who underwent resection for right-sided colon cancer between January 2015 and December 2016 were selected from the Netherlands Cancer Registry and stratified for obstruction. Primary outcome was 5-year OS after excluding 90-day mortality as assessed by the Kaplan-Meier and multivariable Cox regression analysis. 

Results: 

A total of 525 patients (7%) with obstructing and 6891 patients (93%) with non-obstructing right-sided colon cancer were included. Patients with right-sided obstructing colon cancer (OCC) were older and had more often transverse tumour location, and the pathological T and N stage was more advanced than in those without obstruction (p < 0.001). The 90-day mortality in patients with right-sided OCC was higher compared to that in patients with non-obstructing colon cancer: 10% versus 3%, respectively (p < 0.001). The 5-year OS of those surviving 90 days postoperatively was 42% in patients with OCC versus 73% in patients with non-obstructing colon cancer, respectively (p < 0.001). Worse 5-year OS was found in patients with right-sided OCC for all stages. Obstruction was an independent risk factor for decreased OS in right-sided colon cancer (HR 1.79, 95% CI 1.57–2.03).

Conclusion: 

In addition to increased risk of postoperative mortality, a stage-independent worse 5-year OS after excluding 90-day mortality was found in patients with right-sided OCC compared to patients without obstruction.

Original languageEnglish
Article number248
JournalInternational Journal of Colorectal Disease
Volume38
Issue number1
DOIs
Publication statusPublished - 5 Oct 2023

Bibliographical note

Publisher Copyright: © 2023, The Author(s).

Fingerprint

Dive into the research topics of 'Surgical treatment and overall survival in patients with right-sided obstructing colon cancer—a nationwide retrospective cohort study'. Together they form a unique fingerprint.

Cite this