Charles Sabbagh1, Denis Chatelain2, Eric Nguyen-Khac3, Lionel Rebibo4, Jean-Paul Joly5, Jean-Marc Regimbeau6. 1. Department of Digestive and Oncological Surgery, Amiens University Hospital, Amiens Cedex 01, France; Jules Verne University of Picardie, France; INSERM Unit U1088, Jules Verne University of Picardie, France. 2. Jules Verne University of Picardie, France; Department of Pathology, Amiens University Hospital, France. 3. Jules Verne University of Picardie, France; Department of Hepatology and Gastroenterology, Amiens University Hospital, France. 4. Department of Digestive and Oncological Surgery, Amiens University Hospital, Amiens Cedex 01, France. 5. Department of Hepatology and Gastroenterology, Amiens University Hospital, France. 6. Department of Digestive and Oncological Surgery, Amiens University Hospital, Amiens Cedex 01, France; Jules Verne University of Picardie, France; EA4294, Jules Verne University of Picardie, France; Clinical Research Centre, Amiens University Hospital, France. Electronic address: regimbeau.jean-marc@chu-amiens.fr.
Abstract
BACKGROUND: Few studies have assessed access to postoperative chemotherapy and survival in cirrhotic patients with colorectal cancer. Aim of this study was to analyse short and long-term outcomes in these patients compared to non-cirrhotics. METHODS: A retrospective, single-centre, comparative, case-matched study comparing 40 cirrhotic patients who had undergone colorectal resection between January 2006 and January 2014, and a matched cohort of 80 non-cirrhotic patients. Data collection included rate of postoperative outcomes, chemotherapy regimen, overall and disease-free 3-year survival. RESULTS: Cirrhotics had more major postoperative complications than non-cirrhotics (57.5% vs. 26.5%, respectively; p=0.002) but no difference in anastomotic leakage (p=0.1); a higher mortality rate (p=0.0006) was observed in Child-Pugh class B patients. Cirrhotics had no difference in adjuvant chemotherapy rate compared to non-cirrhotics (55% vs. 65%, respectively p=0.8); 3-year overall survival was 71% in the Child A group vs. 92% in non-cirrhotics (p=0.03). CONCLUSION: Despite a higher postoperative complication rate and a lower overall survival of cirrhotic patients compared to non-cirrhotics, cirrhosis had no impact on oncological outcomes and access/tolerance to postoperative chemotherapy. Thus cirrhosis should not be considered as a contraindication to curative treatment of colon cancer.
BACKGROUND: Few studies have assessed access to postoperative chemotherapy and survival in cirrhotic patients with colorectal cancer. Aim of this study was to analyse short and long-term outcomes in these patients compared to non-cirrhotics. METHODS: A retrospective, single-centre, comparative, case-matched study comparing 40 cirrhotic patients who had undergone colorectal resection between January 2006 and January 2014, and a matched cohort of 80 non-cirrhotic patients. Data collection included rate of postoperative outcomes, chemotherapy regimen, overall and disease-free 3-year survival. RESULTS: Cirrhotics had more major postoperative complications than non-cirrhotics (57.5% vs. 26.5%, respectively; p=0.002) but no difference in anastomotic leakage (p=0.1); a higher mortality rate (p=0.0006) was observed in Child-Pugh class B patients. Cirrhotics had no difference in adjuvant chemotherapy rate compared to non-cirrhotics (55% vs. 65%, respectively p=0.8); 3-year overall survival was 71% in the Child A group vs. 92% in non-cirrhotics (p=0.03). CONCLUSION: Despite a higher postoperative complication rate and a lower overall survival of cirrhotic patients compared to non-cirrhotics, cirrhosis had no impact on oncological outcomes and access/tolerance to postoperative chemotherapy. Thus cirrhosis should not be considered as a contraindication to curative treatment of colon cancer.
Authors: Cornelius J van Beekum; Christina Beckmann; Alexander Semaan; Steffen Manekeller; Hanno Matthaei; Lara Braun; Maria A Willis; Jörg C Kalff; Tim O Vilz Journal: Front Med (Lausanne) Date: 2022-06-22