Propensity score-matched analyses of postoperative oncological outcomes of colorectal cancer with versus without oncologic emergency: a single-center retrospective study

Abstract

Abstract Background: While oncologic emergency in colorectal cancer present distinct challenges, the existing literature offers conflicting evidence on the long-term outcomes. Therefore, this study aimed to compare the postoperative oncological outcomes between patients with and without oncologic emergency. Methods: A retrospective evaluation was conducted on patients who had undergone radical surgery for primary stage II and III colorectal cancer between January 2012 and December 2020 at a single center. Patients were classified into three groups (oncologic non-emergency and oncologic emergency due to obstruction or perforation). Two of the three groups were paired using propensity score matching. The primary objective was to compare postoperative long-term outcomes between non-emergency and obstruction or perforation. The secondary objectives were to compare the outcomes between obstruction and perforation, identify the recurrence type among the three groups, and assess the outcomes for the subgroups based on obstruction and perforation features. Results: This study included 524 patients: 348, 140, and 36 patients in the non-emergency, obstruction, and perforation groups, respectively. After propensity score matching, the long-term outcomes of obstruction or perforation were significantly worse than those of non-emergency, whereas those of obstruction and perforation were not significantly different. Regarding recurrence type, peritoneal dissemination in obstruction and local recurrence in perforation were more common than in non-emergency. Conclusion: The long-term outcomes in oncologic emergency were worse than those in oncologic non-emergency, whereas obstruction and perforation outcomes were comparable. The establishment of therapeutic strategies and appropriate management of oncologic emergencies are important future issues.