Key result
Emergency colon cancer surgery is linked to ~79% higher long-term mortality versus elective resection.
Why the study?
The relationship between emergency surgery and long-term mortality in colon cancer patients remains uncertain.
Does emergency surgery increase long-term mortality compared with elective surgery in patients with colon cancer?
Cohort (n=1,139)
No
Does emergency surgery increase long-term mortality compared with elective surgery in patients with colon cancer?
Emergency surgery for colon cancer is associated with a significantly increased risk of long-term mortality compared to elective surgery, highlighting the importance of early detection and treatment.
Supports screening to avert emergency colon cancer surgery; leaves open whether the mortality gap is causal or confounded.
AIM: Emergency surgery is a known predictor for 30-day mortality. However, its relationship with long-term mortality is still a matter of debate. The aim of this study was to analyse the effect of emergency surgery compared with elective surgery on long-term survival. METHOD: Data from the Dutch Colorectal Audit and the Dutch Cancer Centre registry of a large nonacademic teaching hospital were used to analyse outcomes of patients who underwent surgery for colon cancer from 2009 until 2017. Univariable and multivariable Cox regression were used to assess the effect of emergency surgery on long-term mortality with adjustment for patient, tumour and treatment characteristics. RESULTS: A total of 1139 patients with a median follow-up of 40 months (interquartile range 23-65 months) were included. Emergency surgery was performed in 158 patients (14%). The 5-year survival after emergency surgery was 46% compared with 72% after elective surgery. After adjusting for baseline differences there was an independent and significant association between emergency surgery and increased long-term mortality (hazard ratio 1.79, 95% CI 1.28-2.51, P = 0.001). CONCLUSION: Emergency surgery for colon cancer seems to lead to a significantly increased risk of long-term mortality compared with elective surgery. Detection and treatment of early symptoms that can lead to emergency surgery might be the way forward.
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Fahim et al. (2020) conducted a cohort in Colon cancer (n=1,139). Emergency surgery vs. Elective surgery was evaluated on Long-term mortality (5-year survival) (HR 1.79, 95% CI 1.28-2.51, p=0.001). Emergency surgery for colon cancer was associated with significantly increased long-term mortality compared with elective surgery (HR 1.79; 95% CI 1.28-2.51; P=0.001), with 5-year survival of 46% vs 72%.
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