Open AccessLong‐term outcome following curative surgery for malignant large bowel obstruction
Author(s) -
Mulcahy H. E.,
Skelly M. M.,
Husain A.,
O'donoghue D. P.
Publication year - 1996
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.1800830114
Subject(s) - medicine , hazard ratio , surgery , confidence interval , colorectal cancer , perforation , pathological , bowel perforation , bowel obstruction , proportional hazards model , cancer , complication , materials science , punching , metallurgy
This study determined whether the long‐term outcome of patients with obstructing colorectal cancer could be related to conventional pathological prognostic variables or to other clinical, operative or histological features. Ninety‐eight patients with bowel obstruction who had undergone potentially curative surgery and survived the postoperative period were studied. Features related to poor long‐term outcome after a median follow‐nup of 5 years included bowel perforation at initial operation ( P = 0.007), advanced tumour stage ( P < 0.001), poor tumour differentiation ( P = 0.02), mucin production by tumour ( P = 0.004) and the presence of vascular ( P = 0.08) and neural ( P = 0.004) invasion. Outcome was not significantly related to the seniority of the operating surgeon ( P = 0.52), even when this was adjusted for potentially confounding variables (adjusted hazard rate ratio for trainee surgeons 1.4 (95 per cent confidence interval 0.9–2.4), P = 0.16). Conventional prognostic features may help to identify the majority of patients with obstructed colorectal cancer at high risk of tumour recurrence and death.