Clinical ScienceOutcomes of colon resection in patients with metastatic colon cancer

- Overall, 10.8% of patients undergoing colectomy for colon cancer have metastatic disease.
- Postoperative morbidity is significantly high in metastatic colon cancer patients.
- Prolonged ileus is more frequent in patients with metastatic disease.
- Surgery for complications of the primary tumor was more likely in stage IV disease.

BackgroundPatients with advanced colorectal cancer have a high incidence of postoperative complications. We sought to identify outcomes of patients who underwent resection for colon cancer by cancer stage.MethodsThe National Surgical Quality Improvement Program database was used to evaluate all patients who underwent colon resection with a diagnosis of colon cancer from 2012 to 2014. Multivariate logistic regression analysis was performed to investigate patient outcomes by cancer stage.ResultsA total of 7,786 colon cancer patients who underwent colon resection were identified. Of these, 10.8% had metastasis at the time of operation. Patients with metastatic disease had significantly increased risks of perioperative morbidity (adjusted odds ratio [AOR]: 1.44, P = .01) and mortality (AOR: 3.72, P = .01). Patients with metastatic disease were significantly younger (AOR: .99, P < .01) had a higher American Society of Anesthesiologists score (AOR: 1.29, P < .2) and had a higher rate of emergent operation (AOR: 1.40, P < .01).ConclusionsOverall, 10.8% of patients undergoing colectomy for colon cancer have metastatic disease. Postoperative morbidity and mortality are significantly higher than in patients with localized disease.