Lammersen, N.M. (2014) Het Acuut Colorectaal Carcinoom. De gevolgen op korte en langere termijn vergeleken met een electieve patiëntengroep. thesis, Medicine.
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Abstract
Objectives: The primary objective of this study was to assess which pre-, peri- and postoperative risk factors contribute to 30-day mortality in patients with colorectal cancer (CRC), who had non-elective colorectal resection compared to patients who had an elective resection. Secondary objectives were overall mortality and recurrence of CRC. Finally, differences in long term quality of life between the non-elective and elective group were quantitatively explored with the RAND-36. Methods: The medical records of 579 patients (135 non-elective patients and 444 elective patients) who had surgery for CRC between 2007 until 2010 were retrospectively viewed. The follow-up period was at least 3 years. Risk factors were assessed by logistic regression analysis and Cox regression analysis, univariate as multivariate. Results: The 30-day mortality was 10,4% in the non-elective group, versus 4,3% in the elective group. A low albumin level (p=<0,001) and subtotal resection (p=0,007) were related to a higher risk of death within 30 days. After 3 years a mortality rate of 58,5% was found in the non-elective group, versus 30,5% in the elective group. A low albumin level (p=<0,001), a postoperative complication grade (p=<0,001), the AJCC-stadium (p=0,044) and non-curative treatment (p=<0,001) were related to a higher risk of overall mortality. Within 3 years, 22% patients in the non-elective group versus 8,9% in the elective group had developed a recurrence of CRC. The urgency of surgery (p=0,005) and the AJCC-stadium (p=<0,001) contribute to a higher risk of developing a recurrence of CRC. With regard to quality of life, we found a significant deterioration in bowel habits in the non-elective group (p=0,0028). Conclusions: The non-elective group shows in both the short (30-day mortality) and long (overall mortality and recurrence of CRC) term worse outcome measures than the elective group. In this study, the urgency of a CRC procedure was not related to a higher 30-day mortality and higher overall mortality. However, we found a positive relationship between the urgency of a CRC procedure and recurrence of CRC. With regard to long term quality of life, we found significant deterioration in bowel habits in the non-elective group.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Bock, Prof. Dr. G.H. de and Grossmann, Dr. I. |
| Supervisor name: | Klaase, Dr. J.M. and Medisch Spectrum Twente |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:39 |
| Last Modified: | 25 Jun 2020 10:39 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/71 |
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