Is it possible to adopt the same oncological approach in urgent surgery for colon cancer?

Table 1 General characteristics of the patients

	Elective	Urgency	P value
Total	123 (65.1%)	66 (34.9%)
Sex			0.632a
Male	51 (41.5%)	25 (37.9%)
Female	72 (58.5%	41 (62.1%)
Age (yr)
mean ± SD	68.1 ± 11.1	71.8 ± 11.5	0.031b
< 80	107 (87.0%)	49 (74.2%)	0.028a
≥ 80	16 (13.0%)	17 (25.8%)
Type of urgency
Obstruction		47 (71.2%)
Perforation		19 (28.8%)

^aQui-square of Pearson test.

^bt test for independent samples.

Table 2 Clinical and surgical characteristics

	Elective	Urgency	P value	OR and 95%CI
Location			0.004c
Cecum/Ascendent	44 (35.8%)	18 (27.3%)
Transverse	4 (3.3%)	5 (7.6%)
Splenic Angle	0	4 (6.1%)
Descendent	6 (4.9%)	9 (13.6%)
Sigmoid	69 (56.1%)	30 (45.5%)
Surgery1			0.016c
Right colectomy	45 (36.6%)	20 (30.3%)
Transversectomy	2 (1.6%)	2 (3.0%)
Left colectomy	6 (4.9%)	11 (16.7%)
Retosigmoidectomy	66 (53.7%)	27 (40.9%)
Total colectomy	4 (3.3%)	6 (9.1%)
Surgical access			< 0.001a
Open	70 (56.9%)	66 (100%)
Videolaparoscopy	53 (43.1%)	0
Early mortality	6 (4.9%)	10 (15.2%)	0.016a	OR: 3.48, 95%CI: 1.21-10.06

¹With or without enterostomy.

^aQui-square of Pearson’s test.

^bt test for independent samples.

^cExact Fisher’s test.

^dMean and standard deviation.

Table 3 Pathological characteristics of the tumors

	Elective	Urgency	P value
T			0.278c
Tis	2 (1.6%)	0
T1	6 (4.9%)	0
T2	16 (13.0%)	6 (9.1%)
T3	88 (71.5%)	54 (81.8%)
T4	11 (8.9%)	6 (9.1%)
N			0.943a
N0	76 (61.8%)	42 (63.6%)
N1	32 (26.0%)	17 (25.8%)
N2	15 (12.2%)	7 (10.6%)
Staging			0.199c
0	2 (1.6%)	0
I	20 (16.3%)	5 (7.6%)
II	54 (43.9%)	37 (56.1%)
III	47 (38.2%)	24 (36.4%)
Differentiation grade			0.938c
Well	7 (6.0%)	3 (5.0%)
Moderate	101 (87.1%)	52 (86.7%)
Poor	8 (6.9%)	5 (8.3%)
Compromised lymph nodes rated	8.1% ± 16.7	7.9% ± 17.1	0.785e
Angiolymphatic invasion	44 (36.4%)	21 (31.8%)	0.533a
Perineural invasion	19 (16.4%)	7 (11.1%)	0.339a
ALI + PNI	16 (13.0%)	5 (7.6%)	0.257a

^aQui-square of Pearson’s test.

^bt test for independent samples.

^cExact Fisher’s test.

^dMean and SD.

^eMann Whitney test.

ALI: Angiolymphatic invasion; PNI: Perineural invasion.

Table 4 Variables referring to oncological principles for colon cancer surgery

	Elective	Urgency	P value
Longitudinal margin (cm)			0.144a
mean ± SD	6.1 ± 4.7	7.3 ± 5.6
Median	5.0	6.5
Q1 e Q3	3.0 e 8.0	3.1 e 10.0
Number of resected lymph nodes			0.355a
mean ± SD	17.7 ± 8.7	16.6 ± 8.3
Median	16.0	14.0
Q1 e Q3	12.0 e 22.0	12.0 e 20.0
≥ 12 resected lymph nodes	93 (75.6%)	51 (77.3%)	0.798b

^aMann Whitney test.

^bQui-square of Pearson’s test.

Q1: Quartil 1; Q3: Quartil 3.

Table 5 Variables referring to oncological principles for colon cancer surgery according to tumor location

	Right			Left
	Elective	Urgency	P value	Elective	Urgency	P value
Total	45 (69.2%)	20 (30.8%)		76 (63.3%)	44 (36.7%)
Longitudinal margin (cm)1	7.0 (5.0 - 10.0)	6.5 (2.8 - 10.3)	0.270a	4.0 (2.0 - 5.9)	6.5 (4.0 - 9.3)	0.002a
Number of resected lymph nodes1	19.0 (13.0 - 23.0)	19.5 (13.0 - 26.3)	0.446a	15.0 (11.0 - 19.3)	13.0 (11.0 - 17.3)	0.223a
≥12 resected lymph nodes	35 (77.8%)	19 (95.0%)	0.151b	56 (73.7%)	31 (70.5%)	0.832c

¹p25 - p75.

^aMann Whitney test.

^bExact Fisher’s test.

^cQui-square of Pearson’s test.

Table 6 Analysis of early mortality (up to 30 d) after urgent surgery for colon cancer

	Early mortality	Survivals	P value	OR and 95%CI
Total	10 (15.2%)	56 (84.8%)
Sex			0.076a
Male	1 (10.0%)	24 (42.9%)
Female	9 (90.0%)	32 (57.1%)
Age (yr)
mean and SD	84.0 ± 8.7	69.6 ± 10.7	< 0.001b	95%CI: 7.2-21.6
< 80	2 (20.0%)	47 (83.9%)	< 0.001a
≥ 80	8 (80.0%)	9 (16.1%)		OR: 20.89, 95%CI: 3.79-115.00
Type of urgency			0.156a
Obstruction	5 (50.0%)	41 (73.2%)
Perforation	5 (50.0%)	15 (26.8%)
Location			0.245a
Cecum/Ascendent	2 (20.0%)	16 (28.6%)
Transverse	2 (20.0%)	3 (5.4%)
Splenic Angle	1 (10.0%)	3 (5.4%)
Descendent	0	9 (16.1%)
Sigmoid	5 (50.0%)	25 (44.6%)
Surgery			0.059a
Right colectomy	2 (20.0%)	18 (32.1%)
Transversectomy	2 (20.0%)	0
Left colectomy	1 (10.0%)	10 (17.9%)
Retosigmoidectomy	5 (50.0%)	22 (39.3%)
Total colectomy	0	6 (10.7%)
T			0.407a
T2	1 (10.0%)	5 (8.9%)
T3	7 (70.0%)	47 (83.9%)
T4	2 (20.0%)	4 (7.4%)
N			0.100a
N0	9 (90.0%)	33 (58.9%)
N1	0	17 (30.4%)
N2	1 (10.0%)	6 (10.7%)
Staging			0.118a
I	1 (10.0%)	4 (7.1%)
II	8 (80.0%)	29 (51.8%)
III	1 (10.0%)	23 (41.1%)
Differentiation grade			> 0.999a
Well	0	3 (5.4%)
Moderate	9 (90.0%)	43 (76.8%)
Poor	1 (10.0%)	4 (7.1%)
Compromised lymph nodes rate	5.0% ± 15.8	8.4% ± 17.4	0.147c
Angiolymphatic invasion	2 (20.0%)	19 (33.9%)	0.483a
Perineural invasion	1 (10.0%)	6 (10.7%)	> 0.999a
ALI + PNI	1 (10.0%)	4 (7.1%)	0.573a
Margin (cm)1	5.3 (1.6-8.5)	7.0 (3.9-10.0)	0.400c
Number of resected lymph nodes1	12.5 (11.3-17.5)	14.0 (12.0-20.3)	0.306c
≥ 12 resected lymph nodes	7 (70.0%)	44 (78.6%)	0.683a

¹p25-p75.

^aExact Fisher’s test.

^bt test for independent samples.

^cMann Whitney test.

Q1: Quartil 1, Q3: Quartil 3.