caa a22 4500 445333960 CHVBK 20180317142747.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1625-3 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1625-3 Prognostic Significance of Preoperative Bowel Obstruction in Stage III Colorectal Cancer [Elektronische Daten] [Hiroshi Katoh, Keishi Yamashita, Guoqin Wang, Takeo Sato, Takatoshi Nakamura, Masahiko Watanabe] Background: Previous studies have suggested a detrimental prognostic effect of preoperative obstruction proximal to colorectal cancer (CRC). If such a detrimental effect is preserved in each stage of advanced (stage II or III) CRC, we can identify high-risk patients. Methods: We enrolled 641 patients with pathologically confirmed advanced CRC (stage II, n=207; stage III, n=434) who had undergone curative resection of the primary lesion. The association of preoperative obstruction with clinicopathologic parameters was evaluated. Kaplan-Meier analysis and Cox proportional hazard models were used to estimate the effect of preoperative obstruction on disease-free survival in each stage. Results: Preoperative obstruction was seen in 63 patients (9.8%) (stage II, n=16; stage III, n=47). Multivariable analysis showed that preoperative obstruction was significantly associated with preoperative elevation of carcinoembryonic antigen level in patients with colon cancer (odds ratio=3.59; P<0.001), while it was correlated with poor differentiation in patients with rectal cancer (odds ratio=3.99; P=0.016). Preoperative obstruction was a significant prognostic factor in stage III CRC (P<0.001), but not in stage II disease. Multivariable prognostic analysis showed that preoperative obstruction was a remnant independent prognostic factor in stage III CRC. This finding was confirmed by separate analyses of colon and rectal cancer. Preoperative obstruction was associated with systemic recurrence (P=0.003) rather than peritoneal or local recurrence. Conclusions: These findings suggest that preoperative obstruction may predict worse long-term prognosis in patients with stage III CRC and may be a potential clinical marker to identify patients with high-risk stage III CRC. Society of Surgical Oncology, 2011 Katoh Hiroshi Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut Yamashita Keishi Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut Wang Guoqin Department on Community-based Perinatal and Emergency Medicine, Kitasato Clinical Research Center, Kitasato University School of Medicine, Kanagawa, Japan aut Sato Takeo Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut Nakamura Takatoshi Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut Watanabe Masahiko Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2432-2441 1068-9265 18:9<2432 2011 18 10434 https://doi.org/10.1245/s10434-011-1625-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1625-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Katoh Hiroshi Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 700 1- Yamashita Keishi Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 700 1- Wang Guoqin Department on Community-based Perinatal and Emergency Medicine, Kitasato Clinical Research Center, Kitasato University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 700 1- Sato Takeo Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 700 1- Nakamura Takatoshi Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 700 1- Watanabe Masahiko Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2432-2441 1068-9265 18:9<2432 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer