LONG-TERM OUTCOME FOLLOWING CURATIVE SURGERY FOR MALIGNANT LARGE-BOWEL OBSTRUCTION

This study determined whether the long-term outcome of patients with o bstructing colorectal cancer could be related to conventional patholog ical prognostic variables or to other clinical, operative or histologi cal features. Ninety-eight patients with bowel obstruction who had und ergone potentially curative surgery and survived the postoperative per iod were studied. Features related to poor long-term outcome after a m edian follow-up of 5 years included bowel perforation at initial opera tion (P=0.007), advanced tumour stage (P<0.001), poor tumour different iation (P=0.02), mucin production by tumour (P=0.004) and the presence of vascular (P=0.08) and neural (P=0.004) invasion. Outcome was not s ignificantly related to the seniority of the operating surgeon (P=0.52 ), even when this was adjusted for potentially confounding variables ( adjusted hazard rate ratio for trainee surgeons 1.4 (95 per cent confi dence interval 0.9-2.4), P=0.16). Conventional prognostic features may help to identify the majority of patients with obstructed colorectal cancer at high risk of tumour recurrence and death.