Prognostic factors of patients with left-sided obstructive colorectal cancer: post hoc analysis of a retrospective multicenter study by the Japan Colonic Stent Safe Procedure Research Group.

Abstract

BACKGROUND:

There are many reports on the choice of treatment for and prognosis of left-sided obstructive colorectal cancer; however, few studies have focused on the prognostic factors of left-sided obstructive colorectal cancer. Therefore, we analyzed the prognostic factors using a post hoc analysis of a retrospective multicenter study in Japan.

METHODS:

A total of 301 patients were enrolled in this study to investigate the prognostic factors for relapse-free survival. The relationships between sex, age, decompression for bridge to surgery, depth of invasion, lymph node metastasis, postoperative complications, adjuvant chemotherapy, carcinoembryonic antigen, carbohydrate antigen 19-9, neutrophil-to-lymphocyte ratio, and relapse-free survival were examined.

RESULTS:

No change in the decompression method, T3 cancer, negative postoperative complications (grades 0-1 of Clavien-Dindo classification), and adjuvant chemotherapy during Stage III indicated a significantly better prognosis in a Cox univariate analysis. Lymph node metastasis was not selected as a prognostic factor. Excluding patients with <12 harvested lymph nodes (possible stage migration), lymph node metastasis was determined as a prognostic factor. In a Cox multivariate analysis, change in the decompression method, depth of invasion, lymph node metastasis (excluding N0 cases with <12 harvested lymph nodes), and adjuvant chemotherapy were prognostic factors.

CONCLUSIONS:

Similar to those in nonobstructive colorectal cancer, depth of invasion and lymph node metastasis were prognostic factors in left-sided obstructive colorectal cancer, and patients with <12 dissected lymph nodes experienced stage migration. Stage migration may result in disadvantages, such as not being able to receive adjuvant chemotherapy.

• Authors: Shungo Endo, Noriyuki Isohata, Koichiro Kojima, Yoshihiro Kadono, Kunihiko Amano, Hideo Otsuka, Tatsuya Fujimoto, Hideto Egashira, Yoshihisa Saida, Japan Colonic Stent Safe Procedure Research Group
• Journal: World journal of surgical oncology (World J Surg Oncol) Vol. 20 Issue 1 Pg. 24 (Jan 27 2022) ISSN: 1477-7819 [Electronic] England
• PMID: 35086523 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2022. The Author(s).

Topics

• Colorectal Neoplasms (pathology)
• Humans
• Japan (epidemiology)
• Lymph Node Excision
• Lymph Nodes (pathology)
• Neoplasm Recurrence, Local (pathology)
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Stents
• Survival Rate