Academic Journal
Endoscopic obstruction and site-specific metastatic patterns after curative resection of non-metastatic colorectal cancer: A two-center retrospective cohort study.
| Τίτλος: | Endoscopic obstruction and site-specific metastatic patterns after curative resection of non-metastatic colorectal cancer: A two-center retrospective cohort study. |
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| Συγγραφείς: | Zeng H; Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China., Lan K; Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China., Wang X; Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China., Zhu B; Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China., Pan H; Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China., Zhu H; Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China., Xu D; Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China., Lin S; Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China. Electronic address: doclin369@fjmu.edu.cn., Chi P; Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China. Electronic address: chipan363@163.com., Huang Y; Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China. Electronic address: fjxhhy@sina.com. |
| Πηγή: | Surgical oncology [Surg Oncol] 2026 Oct; Vol. 68, pp. 102508. Date of Electronic Publication: 2026 Jul 23. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 9208188 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-3320 (Electronic) Linking ISSN: 09607404 NLM ISO Abbreviation: Surg Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Elsevier Science Original Publication: Oxford ; Boston : Blackwell Scientific Publications, c1992- |
| Ιατρικοί όροι (MeSH): | Colorectal Neoplasms*/complications , Colorectal Neoplasms*/epidemiology , Colorectal Neoplasms*/pathology , Colorectal Neoplasms*/surgery , Intestinal Obstruction*/epidemiology , Intestinal Obstruction*/etiology , Intestinal Obstruction*/pathology , Liver Neoplasms*/epidemiology , Liver Neoplasms*/secondary , Neoplasm Recurrence, Local*/epidemiology , Neoplasm Recurrence, Local*/pathology , Adenocarcinoma*/complications , Adenocarcinoma*/epidemiology , Adenocarcinoma*/secondary , Adenocarcinoma*/surgery, Lung Neoplasms/epidemiology ; Lung Neoplasms/secondary ; Peritoneal Neoplasms/epidemiology ; Peritoneal Neoplasms/secondary ; Colon/pathology ; Rectum/pathology ; China/epidemiology ; Aged ; Female ; Humans ; Male ; Middle Aged ; Follow-Up Studies ; Prognosis ; Retrospective Studies ; Survival Rate ; Colonoscopy |
| Περίληψη: | Purpose: This study aimed to evaluate the association between preoperative endoscopic obstruction (eOB) and site-specific patterns of metastasis in patients with non-metastatic colorectal cancer (CRC) undergoing curative resection. Methods: This two-center retrospective cohort study included 2208 patients with non-metastatic colorectal cancer who underwent radical resection. eOB was present in 520 patients (23.6%). The primary endpoints were liver metastasis-free survival (LiMFS), lung metastasis-free survival (LuMFS), peritoneal metastasis-free survival (PMFS), and local recurrence-free survival (LRFS). Kaplan-Meier curves with log-rank tests were used to compare survival outcomes, with analyses stratified by primary tumor site. Multivariable Cox proportional hazards regression was employed to identify independent risk factors for organ-specific metastases. Results: Multivariable analysis identified endoscopic obstruction (eOB) as an independent risk factor for liver metastasis (HR = 3.00, 95% CI: 1.54-5.86, P = 0.001). Additionally, liver metastasis-free survival (LiMFS) was significantly reduced in patients with eOB, both in the overall cohort and in both the colon cancer and rectal cancer subgroups (all P < 0.001). In contrast, eOB showed no significant association with lung metastasis or local recurrence. Although eOB was associated with shorter peritoneal metastasis-free survival (PMFS) in patients with colorectal cancer (P < 0.05), it was not an independent risk factor after adjustment for T3-4 stage and pN2 stage. Furthermore, no association between eOB and PMFS was observed in rectal cancer. Conclusions: Endoscopic obstruction is a promising clinical marker associated with advanced pathological features and appears to be an independent predictor of liver metastasis in this cohort. However, its incremental predictive value beyond standard pathologic factors and molecular features warrants further prospective validation. (Copyright © 2026. Published by Elsevier Ltd.) |
| Competing Interests: | Declaration of competing interest All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. |
| Contributed Indexing: | Keywords: Colorectal cancer; Endoscopic obstruction; Liver metastasis; Peritoneal metastasis; Risk stratification |
| Entry Date(s): | Date Created: 20260730 Date Completed: 20260911 Latest Revision: 20260916 |
| Update Code: | 20260917 |
| DOI: | 10.1016/j.suronc.2026.102508 |
| PMID: | 42531781 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1879-3320 |
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| DOI: | 10.1016/j.suronc.2026.102508 |