ArticleWorld journal of surgical oncology2025
Factors associated with postoperative recurrence in perforated colorectal cancer: unraveling the high recurrence rate of perforated colorectal cancer.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Independent Prognostic Significance of Perforation in Colorectal Cancer: Insights From a Propensity Score-Matched Cohort Study.Annals of gastroenterological surgery · 2026Article
- Emerging role of low-frequency somatic mutations in cancer relapse: from early detection to precision oncology.Frontiers in oncology · 2026Review
- Prognosis of intensive care unit patients with colorectal cancer.World journal of gastrointestinal oncology · 2025Article
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5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPerforated colorectal cancer exhibits a higher recurrence rate than non-perforated colorectal cancer; however, the reasons for this difference remain unclear. This study identifies factors affecting recurrence in patients with perforated colorectal cancer who underwent R0 surgery.
methodsThis study included consecutive patients with Stage II or III perforated colorectal cancer who underwent radical surgery at a single center between 2007 and 2020. The comparison group included patients with non-perforated, non-obstructive, non-perforated colorectal cancer who underwent surgery during the same period. Clinicopathological background factors (age, sex, localization, surgical procedure, stoma, T stage, lymphatic invasion, venous invasion, differentiation, extent of lymph node dissection, number of dissected lymph nodes, lymph node metastasis, postoperative complications, and 30-day postoperative death) of perforated and non-perforated colorectal cancers were investigated. Factors influencing recurrence were examined in patients who were followed for more than 3 years after surgery, up to 5 years postoperatively.
resultsThis study included 89 perforated and 323 non-perforated cases. The median patient ages were 74 and 73 years in the perforated and non-perforated groups, respectively. In perforated cases, the proportion of T4 stage tumors was significantly higher (39% vs. 18% in non-perforated cases, with p < 0.001). Additionally, the number of lymph node dissections was significantly lower (10 vs. 17 in non-perforated cases, p < 0.001), and the rate of postoperative complications was higher (46% vs. 7% in the non-perforated cases, p < 0.001). Postoperatively, 55 perforated and 284 non-perforated cases were available for follow-up. Univariate analysis revealed that perforation, T4 stage, lymph node metastases, and postoperative complications were associated with significantly higher recurrence rates. Multivariate analysis identified T4 stage and lymph node metastases as independent risk factors.
conclusionsThe recurrence rate of perforated colorectal cancer was higher than that of non-perforated cases, primarily due to advanced disease stages, such as T4 or lymph node metastases. Perforation itself may not directly cause recurrence but reflects cancer progression. Further research is needed to clarify the mechanisms linking cancer progression, perforation, and recurrence.
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