71670 - Survival and oncological outcomes in colorectal cancer patients undergoing urological resections: A National Study Cohort

Introduction

Colorectal cancer (CRC) growing into urinary organs may require en-bloc resections such as total cystectomy (TC), partial cystectomy (PC), or ureter resection (UR). This study aimed to investigate survival and oncological outcomes after CRC in patients operated with addition of urological resections.

Method

Patients undergoing CRC resection in Sweden from 2007 until 2018 were collected via the Swedish Colorectal Cancer Registry. The free text variable “resection other organ” was used to identify CRC undergoing urological resections and subdivided to TC, PC and UR.

Result

A total of 57 907 patients underwent primary CRC surgical resection, of these 1093 patients underwent urological resection (Figure 1). TC, PC and UR were performed in 589, 345 and 159 patients respectively. The vast majority of patients undergoing urinary bladder resection were male, especially regarding rectal cancer patients subjected to TC (205 (92%) male patients).

R0 resection was obtained in 86%, 86% and 84% in TC, PC and UR respectively. 30-day mortality did not differ between groups. 5-years OS rates were 61%, 58%, and 53% in TC, PC and UR (p=0.205). For subgroup analysis patients were divided into four equal groups based on surgical period 2007-2009, 2009-2012, 2012-2016 and 2016-2018. Multivariable analyses adjusted for age, ASA classification, cTNM, pTN, surgical period and type (elective/emergency) revealed higher local recurrence rate in the UR group (p=0.016) while 5-year OS and distant metastases rates did not differ between groups.

Discussion

PC may represent an option to TC in selected patients with CRC overgrowth, while maintaining favourable survival and oncological outcomes.