Emergency presentation of colon cancer is most frequent during summer

被引:41
作者
Gunnarsson, H. [1 ,2 ]
Holm, T. [1 ]
Ekholm, A. [2 ]
Olsson, L. I. [1 ,2 ]
机构
[1] Karolinska Inst, Dept Mol Med & Surg, Nykoping, Sweden
[2] Sormland Cty Council, Clin Res Ctr, Nykoping, Sweden
关键词
Colon cancer; emergency; stage; population-based; survival; risk factors; COLORECTAL-CANCER; DEFINED POPULATION; SURGERY; SURVIVAL; OBSTRUCTION; ADMISSIONS; MANAGEMENT; RESECTION; OUTCOMES; IMPACT;
D O I
10.1111/j.1463-1318.2010.02270.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim The frequency of emergency colon cancer (ECC) was determined using a reproducible definition of 'emergency' to analyse the impact of mode of presentation on long-term prognosis and to search for risk factors for an emergency presentation. Method All patients with colon cancer treated at one Swedish GDH between 1996 and 2005 (N = 604) were eligible. Patients admitted through the emergency room, operated on within three days and with an emergency condition confirmed at surgery were classified as ECC. Survival was analysed by Kaplan-Meier estimates and risk of death by Cox regression. Results The rate of ECC was 97/585 (17%). Patients with ECC were older (median 77 vs 74, P = 0.02), they had more stage III and IV cancers (65% vs 47%; chi 2 = 9.4, P < 0.001) and had a cancer located in the caecum less often (20% vs 33%, chi 2 = 4.3 P = 0.04). ECC were most frequent between June and August (36%), whereas elective cases were evenly distributed throughout the year (chi 2 = 7.8; P = 0.049), Crude 5-year survival was 18% in ECC and 38% in the elective group (P < 0.001). The hazard ratio for death within five years in ECC, with 30-day mortality excluded and adjusted for age and sex was 2.25 (95% CI; 1.42-3.55). Conclusion Emergency presentation of colon cancer is an independent and adverse risk factor for long-term survival. The causes of a seasonal variation need to be clarified.
引用
收藏
页码:663 / 668
页数:6
相关论文
共 26 条
[1]   Emergency First Presentation of Colorectal Cancer Predicts Significantly Poorer Outcomes: A Review of 356 Consecutive Irish Patients [J].
Bass, Gary ;
Fleming, Cathy ;
Conneely, John ;
Martin, Zenia ;
Mealy, Kenneth .
DISEASES OF THE COLON & RECTUM, 2009, 52 (04) :678-684
[2]  
Biondo Sebastiano, 2007, Cir Esp, V82, P89
[3]   Clinical features of colorectal cancer before emergency presentation: a population-based case-control study [J].
Cleary, Jonathan ;
Peters, Tim J. ;
Sharp, Deborah ;
Hamilton, William .
FAMILY PRACTICE, 2007, 24 (01) :3-6
[4]   Colorectal cancer presenting as surgical emergencies [J].
Cuffy, M ;
Abir, F ;
Audisio, RA ;
Longo, WE .
SURGICAL ONCOLOGY-OXFORD, 2004, 13 (2-3) :149-157
[5]  
Davies R J, 2004, Colorectal Dis, V6, P265, DOI 10.1111/j.1463-1318.2004.00598.x
[6]   The effects of population-based faecal occult blood test screening upon emergency colorectal cancer admissions in Coventry and north Warwickshire [J].
Goodyear, S. J. ;
Leung, E. ;
Menon, A. ;
Pedamallu, S. ;
Williams, N. ;
Wong, L. S. .
GUT, 2008, 57 (02) :218-222
[7]   Impact of socioeconomic deprivation on outcome after surgery for colorectal cancer [J].
Hole, DJ ;
McArdle, CS .
BRITISH JOURNAL OF SURGERY, 2002, 89 (05) :586-590
[8]   Postoperative medical complications are the main cause of early death after emergency surgery for colonic cancer [J].
Iversen, L. H. ;
Bulow, S. ;
Christensen, I. J. ;
Laurberg, S. ;
Harling, H. .
BRITISH JOURNAL OF SURGERY, 2008, 95 (08) :1012-1019
[9]   Emergency surgery for colonic cancer in a defined population [J].
Jestin, P ;
Nilsson, J ;
Heurgren, M ;
Påhlman, L ;
Glimelius, B ;
Gunnarsson, U .
BRITISH JOURNAL OF SURGERY, 2005, 92 (01) :94-100
[10]   The impact of blood loss, obstruction and perforation on survival in patients undergoing curative resection for colon cancer [J].
McArdle, CS ;
McMillan, DC ;
Hole, DJ .
BRITISH JOURNAL OF SURGERY, 2006, 93 (04) :483-488