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Prognostic significance of sealed-off perforation in colon cancer: a prospective cohort study

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Authors
Lee, Kil-yong; Park, Ji Won; Song, Inho; Lee, Ki-young; Cho, Sangsik; Kwon, Yoon-Hye; Kim, Min Jung; Ryoo, Seung-Bum; Jeong, Seung-Yong; Park, Kyu Joo
Issue Date
2018-12-04
Publisher
BioMed Central
Citation
World Journal of Surgical Oncology, 16(1):232
Keywords
Sealed-off perforationFree perforationColon cancer
Abstract
Background
Perforated colon cancer is a rare complication, but has a high risk of recurrence. However, most studies have not distinguished sealed-off perforation from free perforation, and the prognosis is unclear. The aim of this study was to evaluate the oncologic outcome of colon cancer with sealed-off perforation.

Methods
Eighty-six consecutive patients who underwent resection for colon cancer with sealed-off or free perforation were included. We defined sealed-off perforation as a colon perforation with localized abscess identified on operative, computed tomography, or pathologic findings, with no evidence of free perforation, including fecal contamination and dirty fluid collection in the peritoneal cavity. Oncologic outcomes were compared between patients with colon cancer with sealed-off perforation and free perforation using a log-rank test and Cox regression analysis.

Results
The sealed-off perforation group included 62 patients, and 24 patients were in the free perforation group. TNM stage and lymphatic, venous, and perineural invasion were similar between the groups. The median follow-up period was 28.9 months (range 0–159). The sealed-off perforation group had better prognosis compared with the free perforation group in terms of progression-free survival (PFS) and overall survival (OS), although there were no statistically significant differences in PFS (5-year PFS 53.7% vs. 40.5%, p = 0.148; 5-year OS 53.6% vs. 22.9%, p = 0.001). However, in multivariable analysis using the Cox progression test, sealed-off perforation did not show a significant effect on cancer progression (p = 0.138) and OS (p = 0.727).

Conclusions
Colon cancer with sealed-off perforation showed no difference in prognosis compared with free perforation.
ISSN
1477-7819
Language
English
URI
http://hdl.handle.net/10371/146964
DOI
https://doi.org/10.1186/s12957-018-1530-3
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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