Carcinoma obstruction of the left colon and long-term prognosis.

BACKGROUND/AIMS: The purpose of this study was to assess the long-term prognosis of patients with carcinoma obstruction of the left colon and determine the associated clinical and pathological characteristics to identify independent prognostic factors.

METHODOLOGY

From 1996 to 2003, 915 patients who underwent curative resection for left-sided colon carcinoma were classified as either the obstruction group (n = 169) or the non-obstruction group (n = 746). Clinical and pathological findings were compared between the 2 groups. Univariate and multivariate analyses were performed to identify independent prognostic factors correlated with survival and disease recurrence.

RESULTS

Distribution of tumor location, tumor size, macroscopic type and histological grade were found to be different in comparisons between the 2 groups. The tumor stage was more advanced in the obstruction group. The overall and disease-free survival rates were significantly lower in the obstruction group compared to the non-obstruction group. However, the results of the multivariate analysis demonstrated that obstruction itself was not an independent prognostic factor. Instead, patient age, serum carcinoembryonic antigen (CEA) level and tumor stage were significant prognostic indicators for long-term outcome.

CONCLUSIONS

Obstruction in left-sided colon cancer was not an independent risk factor for long-term patient outcome. The study results confirmed the conventional prognostic factors of patient age, serum CEA level and tumor stage.