Outcomes of Colon Resection in Patients with Metastatic Colon Cancer

Background: Patients with advanced colorectal cancer have a high incidence of postoperative complications. We sought to identify outcomes of patients who underwent resection for colon cancer by cancer stage.

Methods: The National Surgical Quality Improvement Program database was used to evaluate all patients who underwent colon resection with a diagnosis of colon cancer from 2012 to 2014. Multivariate logistic regression analysis was performed to investigate patient outcomes by cancer stage.

Results: A total of 7,786 colon cancer patients who underwent colon resection were identified. Of these, 10.8% had metastasis at the time of operation. Patients with metastatic disease had significantly increased risks of perioperative morbidity (adjusted odds ratio [AOR]: 1.44, P = .01) and mortality (AOR: 3.72, P = .01). Patients with metastatic disease were significantly younger (AOR: .99, P < .01) had a higher American Society of Anesthesiologists score (AOR: 1.29, P < .2) and had a higher rate of emergent operation (AOR: 1.40, P < .01).

Conclusions: Overall, 10.8% of patients undergoing colectomy for colon cancer have metastatic disease. Postoperative morbidity and mortality are significantly higher than in patients with localized disease.