1Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nogoya, Japan
2Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
3Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Nogoya, Japan
4Department of Surgery, Kasugai Municipal Hospital, Kasugai, Japan
5Department of Surgery, Japanese Red Cross Nagoya Daini Hospital, Nogoya, Japan
Copyright © 2019 by the Korean Cancer Association
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Non-ACO cohort |
ACO cohort |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
All patients |
Propensity score-matched patients |
All patients |
Propensity score-matched patients |
|||||||||
K hospital (n=234) | R hospital (n=446) | p-value | K hospital (n=234) | R hospital (n=446) | p-value | Surgery group (n=27) | TCT group (n=47) | p-value | Surgery group (n=23) | TCT group (n=23) | p-value | |
Age (yr) | 69 (62-75) | 70 (62-77) | 0.54a) | 69 (62-75) | 67 (60-74) | 0.20a) | 70 (64-75) | 71 (63-79) | 0.60a) | 70 (64-74) | 72 (63-81) | 0.54a) |
Sex | ||||||||||||
Male | 148 (63.2) | 258 (57.8) | 0.17b) | 148 (63.2) | 147 (62.8) | 0.92b) | 19 (70.4) | 31 (66.0) | 0.70b) | 16 (69.6) | 16 (69.6) | > 0.99b) |
Female | 86 (36.8) | 188 (42.2) | 86 (36.8) | 87 (37.2) | 8 (29.6) | 16 (34.0) | 7 (30.4) | 7 (30.4) | ||||
Tumor location | ||||||||||||
Rectum | 79 (33.8) | 122 (27.4) | 0.08b) | 79 (33.8) | 68 (29.1) | 0.27b) | 0 | 1 (2.1) | 0.64c) | 0 | 0 | > 0.99b) |
Colon | 155 (66.2) | 324 (72.6) | 155 (66.2) | 166 (70.9) | 27 (100) | 46 (97.9) | 23 (100) | 23 (100) | ||||
Stage | ||||||||||||
II | 119 (50.9) | 226 (50.7) | 0.96b) | 119 (50.9) | 110 (47.0) | 0.41b) | 15 (55.6) | 26 (55.3) | 0.98b) | 11 (47.8) | 11 (47.8) | > 0.99b) |
III | 115 (49.1) | 220 (49.3) | 115 (49.1) | 124 (53.0) | 12 (44.4) | 21 (44.7) | 12 (52.2) | 12 (52.2) | ||||
R status | ||||||||||||
R0 | 232 (99.1) | 432 (96.9) | 0.06b) | 232 (99.1) | 230 (98.3) | 0.69c) | 27 (100) | 44 (93.6) | 0.25c) | 23 (100) | 23 (100) | > 0.99b) |
R1 | 2 (0.9) | 14 (3.1) | 2 (0.9) | 4 (1.7) | 0 | 3 (6.4) | 0 | 0 | ||||
Adjuvant | ||||||||||||
No | 82 (35.0) | 240 (53.8) | < 0.001b) | 82 (35.0) | 92 (39.3) | 0.34b) | 10 (37.0) | 26 (55.3) | 0.13b) | 9 (39.1) | 9 (39.1) | > 0.99b) |
Yes | 152 (65.0) | 206 (46.2) | 152 (65.0) | 142 (60.7) | 17 (63.0) | 21 (44.7) | 14 (60.9) | 14 (60.9) | ||||
Adjuvant regimen | ||||||||||||
Oral fluoropyrimidine | 147 (96.7) | 195 (94.7) | 0.33b) | 147 (96.7) | 133 (93.7) | 0.22b) | 14 (82.4) | 18 (85.7) | > 0.99c) | 11 (78.6) | 13 (92.9) | 0.60c) |
XELOX or FOLFOX | 5 (3.3) | 11 (5.3) | 5 (3.3) | 9 (6.3) | 3 (17.6) | 3 (14.3) | 3 (21.4) | 1 (7.1) |
Values are presented as median (range) or number (%). ACO, acute colorectal obstruction; K hospital, Kasugai Municipal Hospital, Kasugai, Japan; R hospital, Nagoya Daini Red Cross Hospital, Nagoya, Japan; TCT, transanal colorectal tube; XELOX, oxaliplatin plus capecitabine; FOLFOX, oxaliplatin plus infusional 5-fluorouracil and leucovorin; IQR, interquartile range,
a) Mann-Whitney U test,
b) Chi-square test,
c) Fisher exact probability test.
Surgery group (K hospital) (n=23) | TCT group (R hospital) (n=23) | p-value | |
---|---|---|---|
Technical success | 23/23 (100) | 23/23 (100) | > 0.99a) |
Clinical success | 23/23 (100) | 22/23 (95.7) | > 0.99a) |
Hospital stay (day) | 30 (16-40) | 36 (27-44) | 0.09b) |
Anastomosis leakage | 0/23 (0.0) | 2/23 (8.7) | 0.49a) |
Short-term mortality | 1/23 (4.3) | 0/23 (0.0) | > 0.99a) |
Primary resection/anastomosis | 6/23 (26.1) | 20/23 (87.0) | < 0.001a) |
Overall stoma | 17/23 (73.9) | 3/23 (13.0) | < 0.001a) |
Permanent stoma | 2/23 (8.7) | 2/23 (8.7) | > 0.99a) |
LAC | 0/23 (0.0) | 13/23 (56.5) | < 0.001a) |
Values are presented as number (%) or median (IQR). K hospital applied emergency surgery and R hospital applied TCT as the first-line standard treatment for CRC with ACO. K hospital, Kasugai Municipal Hospital, Kasugai, Japan; TCT, transanal colorectal tube; R hospital, Nagoya Daini Red Cross Hospital, Nagoya, Japan; LAC, laparoscopy-assisted colectomy; IQR, interquartile range.
a) Fisher exact probability test,
b) Mann-Whitney U test.
Non-ACO cohort |
ACO cohort |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
All patients |
Propensity score-matched patients |
All patients |
Propensity score-matched patients |
|||||||||
K hospital (n=234) | R hospital (n=446) | p-value | K hospital (n=234) | R hospital (n=446) | p-value | Surgery group (n=27) | TCT group (n=47) | p-value | Surgery group (n=23) | TCT group (n=23) | p-value | |
Age (yr) | 69 (62-75) | 70 (62-77) | 0.54 |
69 (62-75) | 67 (60-74) | 0.20 |
70 (64-75) | 71 (63-79) | 0.60 |
70 (64-74) | 72 (63-81) | 0.54 |
Sex | ||||||||||||
Male | 148 (63.2) | 258 (57.8) | 0.17 |
148 (63.2) | 147 (62.8) | 0.92 |
19 (70.4) | 31 (66.0) | 0.70 |
16 (69.6) | 16 (69.6) | > 0.99 |
Female | 86 (36.8) | 188 (42.2) | 86 (36.8) | 87 (37.2) | 8 (29.6) | 16 (34.0) | 7 (30.4) | 7 (30.4) | ||||
Tumor location | ||||||||||||
Rectum | 79 (33.8) | 122 (27.4) | 0.08 |
79 (33.8) | 68 (29.1) | 0.27 |
0 | 1 (2.1) | 0.64 |
0 | 0 | > 0.99 |
Colon | 155 (66.2) | 324 (72.6) | 155 (66.2) | 166 (70.9) | 27 (100) | 46 (97.9) | 23 (100) | 23 (100) | ||||
Stage | ||||||||||||
II | 119 (50.9) | 226 (50.7) | 0.96 |
119 (50.9) | 110 (47.0) | 0.41 |
15 (55.6) | 26 (55.3) | 0.98 |
11 (47.8) | 11 (47.8) | > 0.99 |
III | 115 (49.1) | 220 (49.3) | 115 (49.1) | 124 (53.0) | 12 (44.4) | 21 (44.7) | 12 (52.2) | 12 (52.2) | ||||
R status | ||||||||||||
R0 | 232 (99.1) | 432 (96.9) | 0.06 |
232 (99.1) | 230 (98.3) | 0.69 |
27 (100) | 44 (93.6) | 0.25 |
23 (100) | 23 (100) | > 0.99 |
R1 | 2 (0.9) | 14 (3.1) | 2 (0.9) | 4 (1.7) | 0 | 3 (6.4) | 0 | 0 | ||||
Adjuvant | ||||||||||||
No | 82 (35.0) | 240 (53.8) | < 0.001 |
82 (35.0) | 92 (39.3) | 0.34 |
10 (37.0) | 26 (55.3) | 0.13 |
9 (39.1) | 9 (39.1) | > 0.99 |
Yes | 152 (65.0) | 206 (46.2) | 152 (65.0) | 142 (60.7) | 17 (63.0) | 21 (44.7) | 14 (60.9) | 14 (60.9) | ||||
Adjuvant regimen | ||||||||||||
Oral fluoropyrimidine | 147 (96.7) | 195 (94.7) | 0.33 |
147 (96.7) | 133 (93.7) | 0.22 |
14 (82.4) | 18 (85.7) | > 0.99 |
11 (78.6) | 13 (92.9) | 0.60 |
XELOX or FOLFOX | 5 (3.3) | 11 (5.3) | 5 (3.3) | 9 (6.3) | 3 (17.6) | 3 (14.3) | 3 (21.4) | 1 (7.1) |
Surgery group (K hospital) (n=23) | TCT group (R hospital) (n=23) | p-value | |
---|---|---|---|
Technical success | 23/23 (100) | 23/23 (100) | > 0.99 |
Clinical success | 23/23 (100) | 22/23 (95.7) | > 0.99 |
Hospital stay (day) | 30 (16-40) | 36 (27-44) | 0.09 |
Anastomosis leakage | 0/23 (0.0) | 2/23 (8.7) | 0.49 |
Short-term mortality | 1/23 (4.3) | 0/23 (0.0) | > 0.99 |
Primary resection/anastomosis | 6/23 (26.1) | 20/23 (87.0) | < 0.001 |
Overall stoma | 17/23 (73.9) | 3/23 (13.0) | < 0.001 |
Permanent stoma | 2/23 (8.7) | 2/23 (8.7) | > 0.99 |
LAC | 0/23 (0.0) | 13/23 (56.5) | < 0.001 |
Values are presented as median (range) or number (%). ACO, acute colorectal obstruction; K hospital, Kasugai Municipal Hospital, Kasugai, Japan; R hospital, Nagoya Daini Red Cross Hospital, Nagoya, Japan; TCT, transanal colorectal tube; XELOX, oxaliplatin plus capecitabine; FOLFOX, oxaliplatin plus infusional 5-fluorouracil and leucovorin; IQR, interquartile range, Mann-Whitney U test, Chi-square test, Fisher exact probability test.
Values are presented as number (%) or median (IQR). K hospital applied emergency surgery and R hospital applied TCT as the first-line standard treatment for CRC with ACO. K hospital, Kasugai Municipal Hospital, Kasugai, Japan; TCT, transanal colorectal tube; R hospital, Nagoya Daini Red Cross Hospital, Nagoya, Japan; LAC, laparoscopy-assisted colectomy; IQR, interquartile range. Fisher exact probability test, Mann-Whitney U test.