Euroasian journal of hepato-gastroenterology

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VOLUME 14 , ISSUE 1 ( January-June, 2024 ) > List of Articles

Original Article

Outcome of Obstructing vs Nonobstructing Colorectal Carcinomas: Comparative Study at Tertiary Care Hospital in Kashmir

Mohd Fazlulhaq, Gowhar Aziz Bhat, Munir Ah Wani, Ajaz Ah Malik, Mohd Israr Ul Haq, Mohd Ehsan Ul Haq

Keywords : CA colon, CA rectum, Colorectal carcinoma, Emergency, Malignant bowel obstruction, Nonobstructing cancer, Obstructing cancer

Citation Information : Fazlulhaq M, Bhat GA, Wani MA, Malik AA, Ul Haq MI, Ul Haq ME. Outcome of Obstructing vs Nonobstructing Colorectal Carcinomas: Comparative Study at Tertiary Care Hospital in Kashmir. Euroasian J Hepatogastroenterol 2024; 14 (1):75-80.

DOI: 10.5005/jp-journals-10018-1421

License: CC BY-NC 4.0

Published Online: 12-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Colorectal cancer (CRC) is the commonly diagnosed malignancy presenting either in obstruction or without obstruction. Bowel obstruction (BO) is usually a complication of advanced cancer, significantly reducing the quality of life. We aimed to study the outcomes of these obstructed colorectal cancers requiring emergency intervention and compare it with nonobstructed cancers. Materials and methods: In our observational comparative study, patients were divided into groups on basis of their presentation and site of lesion: nonobstructing colon group/obstructing colon group nonobstructing rectum group/obstructing rectum group. Results: A total of 232 patients with known modes of presentation between 2015 and 2018 were included; 144 colonic, 88 rectal carcinomas with 71 being completely obstructive ones. Our study showed higher recurrence in obstructive groups with local recurrence being more common. The median interval for recurrence was early in obstructive group (p < 0.001*). The overall 5-year survival rates were better in Nonobstructing colon group, (p = –0.046* in OR vs NOR) (p = –0.031* in OC vs NOC). 5-year disease-free survival rates statistically insignificant (p = 0.203 in NOC and OC groups), (p = 0.307 in NOR and OR groups). Immediate post-op, complications except for SSI, there was no significant difference between the two groups. Our study showed higher proportion of R0 resection in NOC groups as compared with obstructive groups (p = 0.021* in in OC vs NOC and p = 0.037* in OR vs NOR) with better lymph node retrieval in NOC groups. Conclusion: On comparing outcome of patients who had completed multi-modal therapy in both groups, there was significantly better outcome for patients who have presented without obstruction.


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  1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424. DOI: 10.3322/caac.21492.
  2. Deans GT, Krukowski ZH, Irwin ST. Malignant obstruction of the left colon. Br J Surg 1994;81:1270–1276. DOI: 10.1002/bjs.1800810905.
  3. Franklyn J, Varghese G, Raghunath R, et al. Oncological outcomes of obstructed locally advanced rectal cancer in the era of multi-modal therapy. Int Surg J 2018;5:3695–3703. 10.18203/2349-2902.isj20184647.
  4. Peedikayil MC, Nair P, Seena SM, et al. Colorectal cancer distribution in 220 Indian patients undergoing colonoscopy. Indian J Gastroenterol 2009;28(6):212–215. DOI: 10.1007/s12664-009-0087-z.
  5. Patil PS, Saklani A, Gambhire P, et al. Colorectal cancer in India: An audit from a tertiary center in a low prevalence area. Indian J Surg Oncol 2017;8(4):484–490. DOI: 10.1007/s13193-017-0655-0.
  6. Atsushi I, Mitsuyoshi O, Kazuya Y, et al. Long-term outcomes and prognostic factors of patients with obstructive colorectal cancer: A multicenter retrospective cohort study. World J Gastroenterol 2016;22:5237–5245. DOI: 10.3748/wjg.v22.i22.5237.
  7. Yang Z, Wang L, Kang L, et al. Clinicopathologic characteristics and outcomes of patients with obstructive colorectal cancer. J Gastrointest Surg 2011;15:1213–1222. DOI: 10.1007/s11605-011-1563-1.
  8. Biondo S, Kreisler E, Millan M, et al. Differences in patient postoperative and long term outcomes between obstructive and perforated colonic cancer. Am J Surg 2008;195:427–432. DOI: 10.1016/j.amjsurg.2007.02.027.
  9. Lee CHA, Kong JCH, Heriot AG, et al. Short-term outcome of emergency colorectal cancer surgery: results from Bi-National colorectal cancer audit. Int J Colorectal Dis 2019;34:63–69. DOI: 10.1007/s00384-018-3169-5.
  10. Azin A, Hirpara DH, Draginov A, et al. Adequacy of lymph node harvest following colectomy for obstructed and nonobstructed colon cancer. J Surg Oncol 2020;1–9. DOI: 10.1002/jso.26274.
  11. Nikolovski A, Dervishov K, Ulusoy C. Does emergency surgery have impact on lymph node harvest in colorectal cancer surgery? Arch Clin Exp Med 2022;7(2):24–28. DOI: 10.25000/acem.1071023.
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