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dc.contributor.authorMcDermott, Frank
dc.identifier.citationFrago R et al. Post-operative and oncological 3-year follow-up outcomes in stage 2 colonic cancer in the emergency and elective setting: a cohort study [published online ahead of print, 2020 Apr 7]. ANZ J Surg. 2020;10.1111/ans.15876. doi:10.1111/ans.15876en_US
dc.description.abstractBackground: Stage 2 colonic cancer comprises a heterogeneous group of patients with a spectrum of disease, from invasion of the sub-serosa to tumour perforation into visceral peritoneum/adjacent organs. This study evaluates the post-operative outcomes and prognostic factors of patients with both emergency and elective presentations of stage 2 colonic cancer treated with curative intent. Methods: Retrospective analysis of a prospectively maintained database of adult patients (emergency and elective) who underwent curative surgery for stage 2 colonic cancer in a single tertiary referral centre between 2007 and 2016 was conducted. Multivariate analysis was performed to identify prognostic factors. Measured variables included demographics, complications, histology, disease-free survival and overall survival (OS). Results: A total of 428 patients with stage 2 colonic cancer received curative surgical resection, and negative resection margins were achieved in all cases: T3 group (stage 2A): 316 (73.8%); T4a group (stage 2B): 78 patients (18.2%); and T4b group (stage 2C): 34 (8%). There were 187 (45.7%) post-operative complications, 32 (7.5%) anastomotic leaks and eight (1.9%) 30-day mortalities. Eighty patients (19.3%) died during the follow-up. During the follow-up period, 45 patients developed recurrence (all distant). Multivariate analysis identified age >70 years, American Society of Anesthesiologists grades III-IV and male gender as factors associated with poor OS, while recurrence was higher in those aged over 70 years and with stages 2B-2C disease. Conclusion: Surgical morbidity in patients with stage 2 colonic cancer who have undergone curative surgery is high. Older and more co-morbid patients have poorer OS. Stages 2B and 2C colon cancer patients have worse prognosis than those with stage 2A regarding recurrence. Future larger data sets are required to determine the role of transmural spread as a prognostic factor.en_US
dc.rights© 2020 Royal Australasian College of Surgeons.en_US
dc.subjectmorbidity and mortalityen_US
dc.subjectstage 2 colon canceren_US
dc.subjectthree-year follow-upen_US
dc.subjectWessex Classification Subject Headings::Oncology. Pathology.en_US
dc.titlePost-operative and oncological 3-year follow-up outcomes in stage 2 colonic cancer in the emergency and elective setting: a cohort studyen_US
dc.typeJournal Articleen_US
dc.identifier.journalANZ Journal of Surgeryen_US
dc.type.versionIn press (epub ahead of print)en_US
dc.description.admin-notepublished version, accepted version (12 month embargo), submitted versionen_US

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