Emergency resection for stage II colon cancer: patterns of recurrence and prognostic factors

Abstract

Background: The prognosis in colon cancer patients who undergo emergency curative resection remains uncertain. This study aimed to analyze the oncological outcomes in stage II colon cancer patients who underwent emergency or elective colon resection and identify the prognostic factors for recurrence following emergency resection. Methods: Patients in this study underwent curative resection for stage II colon cancer between March 2008 and December 2020. Based on surgical condition, patients were divided into two groups: emergency and elective. The two groups were compared regarding clinicopathological features and postoperative recurrence. Prognostic factors for recurrence were analyzed in the emergency resection group. Results: Among 161 patients, 60 and 101 patients were emergency group and elective group, respectively. The emergency group had significantly lower adequately harvested lymph nodes than the elective group (p=0.02). The emergency group had significantly poorer disease-free survival compared to the elective group (p=0.019). The most common recurrence site was local recurrence. No statistically significant difference was observed between the two groups in recurrence site. The presence of lymphovascular invasion and clinical perforation were prognostic factors for recurrence in the emergency resection group. Conclusion: Emergency resection for stage II colon cancer is associated with poor disease-free survival compared to elective resection. The prognosis may improve by performing appropriate radical surgery including extensive lymph node dissection. Adjuvant chemotherapy should be performed following emergency surgery for stage II colon cancer, especially when lymphovascular invasion or colonic perforation is identified.