Surgical Outcome in Patients with Gastrointestinal Malignancies; A Report from a Large Referral Hospital, 2008-2010

Abstract

BACKGROUND

A considerable portion of gastrointestinal malignancies undergoes surgery without curative resection. This study was conducted to assess surgical outcome in patients with gastrointestinal cancers.

METHODS

We reviewed individuals with esophagus, stomach, colon and rectum cancers admitted for surgical treatment after initial preoperative evaluations. Surgical outcome, stage of tumors and 1 and 5 years survival rate were assessed and analyzed.

RESULTS

Two hundred and fifty five patients with esophagus, stomach and colorectal malignancies, who were admitted for surgical resection, were reviewed. Two hundred and twenty two patients were underwent surgery but tumor was not resected in 41 cases (18.6%). Based on pathological assessment, stage of tumors was III or IV in 108 individuals (48.9%). The proportion of tumor with advanced stage was significantly higher in patients with gastroesophageal cancers than those with colorectal malignancies (62.6% versus 31.6%), p‹0.0001). The proportion of non-resectable tumor was also significantly higher in patients with esophageal and gastric cancers (p =0.0001). Palliative surgery was done in 26.1% of patients treated by surgical resection. The proportion of palliative surgery was significantly lower in patients with gastric cancer (p =0.001). 1 and 5-year survival were significantly longer in colorectal cancer and those with curative surgery (p =0.001). Survival of patients with palliative resection was the same as patient without tumor resection.

CONCLUSION

Despite preoperative evaluations, there are still a considerable proportion of patients who are diagnosed as inoperable during surgery. Further researches seem to be necessary in order to provide more precise preoperative staging. Screening programs should also be considered for GI cancers in high-risk areas. It seems that palliative resection would not improve survival of patients with advanced GI malignancies.