Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?

OBJECTIVES: The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma. METHODS: Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorec-tal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intesti-nal obstruction. The p-values< 0.05 were considered to indicate statistical significance. Simple Cox proportion-al hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer. RESULTS: Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treat-ment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n= 593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n= 3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for oth-er prognostic variables, intestinal obstruction had a statistically significant negative correlation with the surviv-al rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p= 0.008). CONCLUSIONS: The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.