The outcomes of multivisceral resection for primary T4b colorectal cancer in a tertiary referral centre: a propensity score matching analysis

Abstract

IntroductionA multivisceral resection (MVR) is often necessary for patients with colorectal cancer (CRC) because the tumour must be removed en bloc with the infiltrated tissues. The outcomes of MVR are variably presented in the literature. This study aimed to analyse mortality and morbidity of MVR in patients with CRC.Material and methodsThis retrospective study was performed using the Department of General and Colorectal Surgery database of 2204 patients operated on for CRC. Patients with MVR due to stage pT4b primary CRC were the study group. Patients with no sign of intraoperative infiltration into contiguous structures who had undergone a traditional resection qualified for the control group. Mortality and morbidity for both groups were compared using a propensity score matching analysis.ResultsPatients with no sign of intraoperative infiltration into contiguous structures, who had undergone a traditional resection, qualified for the control group, while 117 patients with MVR due to stage pT4b primary CRC were included in the study group. Early post-operative mortality was not significantly increased in the MVR group (3.4% vs. 1.4%; p = 0.284). The mean operative time was significantly longer in the MVR group (p < 0.001). The 5-year absolute survival rate was significantly higher in the MVR group (76.7%) than in the control group (57.0%; p = 0.004).ConclusionsMVR in pT4 CRC is not linked to a higher risk of significant post-operative complications compared to standard resections. Patients with CRC with involvement of contiguous structures, who undergo an MVR, do not appear to have worse long-time outcome than those who do not have involvement of contiguous structures.