Oncologic outcome of colon cancer with perforation and obstruction

Purpose Perforation and obstruction in colorectal cancer are poor prognostic factors. We aimed to evaluate the oncological outcomes of patients with colon cancer presenting with perforation or obstruction. Methods A total of 260 patients underwent surgery for colon cancer between January 2015 and December 2017. Among them, 54 patients who underwent emergency surgery for perforated (n = 32) or obstructive (n = 22) colon cancer were included. Results The perforation (PG, n = 32) and obstruction groups (OG, n = 22) did not differ significantly in age ( p = 0.486), sex ( p = 0.821), tumor stage ( p = 0.221), tumor location ( p = 0.895), histologic grade ( p = 0.173), or 3-year overall survival rate (55.6% vs. 50.0%, p = 0.784). However, the PG had a higher postoperative complication rate (44% vs. 17%, p = 0.025), longer intensive care unit stay (4.8 days vs. 0.8 days, p = 0.047), and lower 3-year recurrence-free survival (42.4% vs. 78.8%, p = 0.025) than the OG. In the multivariate analysis, perforation was significantly increased risk of recurrence (hazard ratio = 3.67, 95% confidence interval: 1.049–12.839, p = 0.042). Conclusion Patients with colon cancer initially presenting with perforation had poorer recurrence-free survival, higher postoperative complication rates, and longer ICU stays than those who had obstruction.