Peri-Operative Bowel Perforation in Early Stage Colon Cancer is Associated with an Adverse Oncological Outcome

Belt, Eric; Stockmann, H. B. A. C.; Abis, G S A; Boer, Jonne M. de; Klerk, Elly S.M. de Lange–de; Egmond, Marjolein van; Meijer, Gerrit A.; Oosterling, Steven J.

doi:10.1007/s11605-012-2053-9

Cited by 17 publications

(9 citation statements)

References 26 publications

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“…In accordance with Belt et al. (2012), we believe that this may be attributable to a peritoneal spill of tumour cells. The last parameter highlighted by the aforementioned guidelines and also found important in our study is preoperative serum CEA level.…”

Section: Discussionsupporting

confidence: 92%

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

et al. 2020

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Section: Discussionsupporting

confidence: 92%

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

et al. 2020

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“…In our study, postoperative local recurrence of cT4 patients was similar to those of other studies [17][18][19][20][21][22]. If the tumor invades the serosa, seeding tumor cells may remain in the peritoneal cavity.…”

Section: Discussionsupporting

confidence: 89%

Clinical characteristics and oncologic outcomes in patients with preoperative clinical T3 and T4 colon cancer who were staged as pathologic T3

et al. 2020

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Purpose: Clinically suspected T4 stage colon cancer from a preoperative exam is often diagnosed as T3 stage colon cancer pathologically after surgery, raising concerns about understaging. The aims of this study were to compare the survival of clinical T3 and T4 colon cancer patients who had received a pathologic T3 stage diagnosis postoperatively. Methods: Patients who were diagnosed with pathologic T3 stage colon cancer postoperatively were reviewed. Patients with clinically suspected T3 or T4 stage cancer on preoperative exam were enrolled in the study. We compared patient demographics and survival of the cT3 and cT4 groups. Results: Out of the 536 patients with pT3 colon cancer, 503 patients were cT3 (93.8%) and 33 patients were cT4 (6.2%) preoperatively. The most common reason for suspected clinical T4 stage cancer was free perforation (78.8%). There were no statistically significant differences between the 5-year overall survival and the total 5-year disease-free survival (DFS) between the cT3 and cT4 groups; however, local recurrence was significantly higher in the cT4 group (local 5-year DFS: 98.6% vs. 84.0%, P < 0.001). Multivariate analysis showed cT stage was associated with local recurrence, but the association was not statistically significant (P = 0.056). Conclusion: Preoperative clinically suspected T4 stage colon cancer showed inferior local recurrence despite a postoperative pathologic diagnosis of T3 stage cancer. It is necessary to address the shortcomings of pathologic exams in the matter of the understaging of T4 colon cancer, and to reinforce the treatment for local control in patients with cT4 colon cancer.

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“…The relationship between anastomotic leakage and oncological outcome is a controversial issue. Although several studies have shown a relationship between anastomotic leakage and disease recurrence as well as overall survival [ 50 , 51 , 52 , 53 ], other studies have not found an adverse effect on oncological outcome [ 54 , 55 ]. Nonetheless, recent meta-analyses showed increased local recurrence and reduced long-term survival from colorectal cancer following anastomotic leakage [ 56 , 57 , 58 , 59 ].…”

Section: Anastomotic Leakage and Bacterial Translocationmentioning

confidence: 99%

“…Despite improvements in surgical equipment and techniques, patients undergoing colorectal surgery are at risk for development of infectious complications, such as surgical site infection (SSI) and anastomotic leakage (AL) [ 104 , 105 ]. Several studies have also linked AL with increased tumor recurrence and higher cancer-specific mortality [ 50 , 51 , 52 ].…”

Section: Oral Antibiotics For Decontamination Of the Digestive Tramentioning

confidence: 99%

Surgery for Colorectal Cancer: A Trigger for Liver Metastases Development? New Insights into the Underlying Mechanisms

2021

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Surgery is a crucial intervention and provides the best chance of cure for patients with colorectal cancer. Experimental and clinical evidence, however, suggests that paradoxically surgery itself may precipitate or accelerate tumor recurrence and/or liver metastasis development. This review addresses the various aspects of surgery-induced metastasis formation and sheds light on the role of inflammation as potential trigger for metastasis development. Understanding these mechanisms may provide potential new perioperative interventions to improve treatment outcomes, and as such could transform the perioperative timeframe from a facilitator of metastatic progression to a window of opportunity to reduce the risk of liver metastasis development. Ultimately, this can potentially improve long-term survival rates and quality of life in patients with colorectal cancer.

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Peri-Operative Bowel Perforation in Early Stage Colon Cancer is Associated with an Adverse Oncological Outcome

Cited by 17 publications

References 26 publications

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

Clinical characteristics and oncologic outcomes in patients with preoperative clinical T3 and T4 colon cancer who were staged as pathologic T3

Surgery for Colorectal Cancer: A Trigger for Liver Metastases Development? New Insights into the Underlying Mechanisms

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