Comparison of postoperative prognoses for resectable colorectal cancer with vs. without oncologic emergency using propensity score‑matched analyses: A single-center retrospective observational study

Imaizumi,Ken; Kasajima,Hiroyuki; Sato,Kentaro; Ichimura,Kentaro; Sato,Aya; Yamana,Daisuke; Tsuruga,Yosuke; Umehara,Minoru; Kurushima,Michihiro; Nakanishi,Kazuaki

doi:10.3892/ol.2024.14704

Comparison of postoperative prognoses for resectable colorectal cancer with vs. without oncologic emergency using propensity score‑matched analyses: A single-center retrospective observational study

Authors:
- Ken Imaizumi
- Hiroyuki Kasajima
- Kentaro Sato
- Kentaro Ichimura
- Aya Sato
- Daisuke Yamana
- Yosuke Tsuruga
- Minoru Umehara
- Michihiro Kurushima
- Kazuaki Nakanishi
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Affiliations: Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido 041‑8680, Japan
Published online on: September 27, 2024 https://doi.org/10.3892/ol.2024.14704
Article Number: 571
Copyright: © Imaizumi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

While oncological emergencies in colorectal cancer present distinct challenges, existing literature offers conflicting evidence regarding long‑term outcomes. Therefore, the present study compared the postoperative prognoses between patients with and without oncological emergencies. A retrospective evaluation was conducted on patients who had undergone radical surgery for pathological stages II and III colorectal cancer at a single center between January 2012 and December 2020. Patients were classified into the non‑emergency and oncological emergency groups. The status of oncologic emergency was divided into obstruction and perforation. The outcomes were compared using propensity score matching. The primary objective was to compare the postoperative prognoses between non‑emergency and oncological emergency situations. The secondary objectives included comparing prognoses between obstruction and perforation, identifying the type of recurrence depending on the status of oncologic emergency, and assessing the effect of adjuvant chemotherapy for oncologic emergencies. This study included 524 patients. After propensity score matching, the prognoses of oncological emergencies were worse compared with those without any emergency, whereas those of obstruction and perforation did not significantly differ. Regarding the type of recurrence, peritoneal dissemination in obstruction and local recurrence in perforation was more common compared with that in non‑emergency cases. Adjuvant chemotherapy improved the recurrence‑free survival for cases with oncological emergencies. The prognoses in cases with oncological emergencies could be worse compared with those without any emergency, whereas obstruction and perforation outcomes can be comparable. The administration of adjuvant chemotherapy should be strongly considered for oncological emergencies.

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