Purpose@#The
prognostic factors in obstructive
colon cancer have not been clearly identified. We aimed to identify the
prognostic factor to establish optimal
treatment strategy in obstructive
colon cancer . @*
Methods @#
Patients who underwent
surgery for primary
colon cancer in stages II and III with symptomatic obstruction from 2004 to 2010 in six
hospitals were retrospectively collected. Clinicopathological and surgical outcomes were compared between
stent insertion and emergent
surgery group. Multiple
regression analysis and
survival curve
analysis were used to identif y the
prognostic factors in symptomatic obstructive
colon cancer . @*Results@#Among 210
patients , 168
patients (80.0%) underwent
stent insertion followed by
surgery and 42
patients (20.0%) underwent emergent
surgery . Laparoscopic approach (55.4% vs. 23.8%, p< 0.001) and adequate
lymph node (LN) harvest (≥12) (93.5% vs. 69.0%, p < 0.001) were significantly higher in
stent insertion group. In multiple
regression analysis , emergent
surgery (
hazard ratio [HR], 2.153; 95%
confidence interval [CI], 1.031–4.495), vascular invasion (HR, 6.257; 95% CI, 2.784–14.061), and omitting
adjuvant chemotherapy (HR, 3.107; 95% CI, 1.394–6.925) were independent poor
prognostic factors in 5-year overall
survival , and N stage (N1 HR, 3.095; 95% CI, 1.316–7.284; N2 HR, 4.156; 95% CI, 1.671–10.333) was the only poor
prognostic factor in 5-year
disease-free survival . @*Conclusion@#In symptomatic obstructive
colon cancer , emergent
surgery , N stage, vascular invasion, and omission of
adjuvant chemotherapy were independent poor
prognostic factors .
Stent insertion is suggested as the initial
treatment for symptomatic obstructive
colon cancer , and
adjuvant chemotherapy is recommended, especially when vascular invasion or LN
metastasis is confirmed.