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Urgent surgery in colon cancer has no impact on survival

Pia Antony, Julian C Harnoss, Rene Warschkow, Bruno Schmied, Martin Schneider, Ignazio Tarantino & Alexis Ulrich

abstract

BACKGROUND AND OBJECTIVES
Despite advances in early detection of colon cancer, a minority of patients still require urgent surgery. Whether such urgent conditions result in poor outcome remains a topic of debate.

METHODS
Using a prospectively maintained database, patients suffering exclusively from colon cancer and receiving either elective or emergent resection between 2001 and 2014 were analyzed with respect to overall, disease-specific, and relative survival using Cox regression and propensity score analyses.

RESULTS
From a total of 877 patients analyzed, 2.7% (24) presented with complications requiring urgent surgery. Propensity-scoring identified strongly biased patient characteristics (0.097 ± 0.069 vs 0.028 ± 0.043; P < 0.001). An unadjusted Cox proportional hazards regression analysis revealed urgent surgery as a statistically significant prognostic factor with an approximately 207% increased risk of mortality (hazard ratio [HR] = 3.07; 95% confidence interval [CI]: 1.62-5.81; P = 0.003). After adjusting the data according to the propensity score analysis, urgent surgery was not associated with a decreased overall (HR = 1.67; 95%CI; 0.84-3.36; P = 0.174), disease-specific (HR = 1.62; 95% CI; 0.81-3.24; P = 0.201) or relative survival (HR = 1.86; 95% CI: 0.92-3.79; P = 0.086).

CONCLUSIONS
After risk-adjustment, using multivariable Cox regression and propensity score analyses, no significant disadvantage could be noted with regard to overall, disease-specific, or relative survival in patients with exclusively colon cancer who received emergent oncological resection.
   
citation Antony P, Harnoss J C, Warschkow R, Schmied B, Schneider M, Tarantino I, Ulrich A. Urgent surgery in colon cancer has no impact on survival. J Surg Oncol 2019; 119:1170-1178.
   
type journal paper/review (English)
date of publishing 12-04-2019
journal title J Surg Oncol (119/8)
ISSN electronic 1096-9098
pages 1170-1178
PubMed 30977910
DOI 10.1002/jso.25469