Erratum: Resection of Obstructive Left-Sided Colon Cancer at a National Level: A Prospective Analysis of Short-Term Outcomes in 1,816 Patients

Background/Aims: The prematurely closed Stent-In II trial in patients with left-sided obstructive colon cancer may have influenced clinical decision making in The Netherlands. The aim of this study was to evaluate treatment of left-sided malignant colon obstruction at a population level since then. Methods: Short-term outcomes of all patients who underwent resection for left-sided obstructive colon cancer between 2009 and 2012 were assessed based on a prospective national registry. Results: In total, 1,816 evaluable patients were included; acute resection was performed in 1,485 (81.8%), and endoscopic stent or decompressing stoma followed by resection in 196 (10.8%) and 135 (7.4%), respectively. The use of endoscopic stenting significantly decreased from 18% (2009) to 6% (2012). Overall 30-day or in-hospital mortality rate was 6.9, 5.6, and 3.7%, respectively (p = 0.107). Mortality rate after acute resection was 2.9% in patients >70 years, but mortality rates up to 32.2% were observed in high-risk elderly patients. Conclusion: Acute resection as first choice treatment seems justified for patients >70 years of age given a mortality rate of 3%. For the elderly frail patients, mortality rates over 30% after acute resection stress the need for alternative treatment strategies.

背景/目的：由于 Stent-In II 试验在左侧梗阻性结直肠癌患者中提前终止，可能影响了荷兰的临床决策。本研究旨在评估自那时起在人群层面上左侧恶性结肠梗阻的治疗。方法：基于前瞻性国家登记系统，评估了2009年至2012年间接受左侧梗阻性结直肠癌切除术的所有患者的短期结果。结果：共纳入1,816例可评估患者；急性切除术在1,485例（81.8%）患者中实施，内镜支架或减压造口随后进行切除术分别在196例（10.8%）和135例（7.4%）患者中实施。内镜支架的使用显著从2009年的18%降至2012年的6%。总体而言，30天或住院死亡率分别为6.9%、5.6%和3.7%（p = 0.107）。急性切除术后的死亡率在70岁以上患者中为2.9%，但在高风险老年患者中观察到死亡率高达32.2%。结论：鉴于3%的死亡率，对于70岁以上患者，急性切除术作为首选治疗方案似乎是合理的。对于老年体弱患者，急性切除术后的死亡率超过30%，这强调了需要采用替代治疗方案的需求。