D.S. Shvets1,2, O.I. Kaganov1,2, A.E. Orlov1,2, A.M. Kozlov1,2, S.A. Frolov1,2, N.I. Mikolenko2, T.O. Kaganova1
1Samara State Medical University, Samara
2Samara Regional Clinical Oncology Dispensary, Samara
Shvets Denis S. ― oncologist of the abdominal department №2 of the Samara Regional Clinical Oncology Dispensary
50 Solnechnaya Str., Samara, 443031, Russian Federation, tel. +7-906-344-04-36, e-mail: shvetsdеnis@rambler.ru, SPIN-code: 3682-5192, ORCID ID: 0009-0000-2934-9933
Abstract. Every year, more than 1 million new cases of colorectal cancer are registered around the world. 10-15% of newly diagnosed patients already have distant metastases. The presence of intestinal obstruction dictates the need to perform surgical treatment at the first stage in order to eliminate this complication: what volume of surgery should be performed: to form a colostomy or cytoreductive R2 resection to remove the primary tumor focus?
The goal of the work is to improve the results of treatment of patients with metastatic colorectal cancer complicated by intestinal obstruction by optimizing the tactics of surgical treatment.
The study is based on an analysis of the treatment of 202 patients with metastatic colorectal cancer complicated by intestinal obstruction. The patients were divided into two groups: group 1 included 119 patients in whom the first stage of treatment included removal of the primary tumor focus. Group 2 included 83 patients who underwent only palliative surgery aimed at eliminating intestinal obstruction without removing the primary tumor.
Study results. The one-year survival rate in group 1 was 37 people (31,1%), and in group 2 ― 51 (61,4%) patients. Multivariate analysis identified predictors that influence one-year survival and treatment effectiveness: the number of internal organs affected by metastases, albumin/globulin ratio, Krebs leukocyte index, MCV index, and the regimen of upcoming targeted therapy. Based on the analysis, indications for removal of the primary tumor were determined.
Key words: metastatic colorectal cancer, intestinal obstruction, adverse events of chemotherapy, palliative surgery, cytoreductive surgery ― R2 resection.