Management of colorectal cancer in patients with cirrhosis: A retrospective, case-matched study of short- and long-term outcomes

Background: Few studies have assessed access to postoperative chemotherapy and survival in cirrhotic patients with colorectal cancer. Aim of this study was to analyse short and long-term outcomes in these patients compared to non-cirrhotics. Methods: A retrospective, single-centre, comparative, case-matched study comparing 40 cirrhotic patients who had undergone colorectal resection between January 2006 and January 2014, and a matched cohort of 80 non-cirrhotic patients. Data collection included rate of postoperative outcomes, chemotherapy regimen, overall and disease-free 3-year survival. Results: Cirrhotics had more major postoperative complications than non-cirrhotics (57.5% vs. 26.5%, respectively; p = 0.002) but no difference in anastomotic leakage (p = 0.1); a higher mortality rate (p = 0.0006) was observed in Child-Pugh class B patients. Cirrhotics had no difference in adjuvant chemotherapy rate compared to non-cirrhotics (55% vs. 65%, respectively p = 0.8); 3-year overall survival was 71% in the Child A group vs. 92% in non-cirrhotics (p = 0.03). Conclusion: Despite a higher postoperative complication rate and a lower overall survival of cirrhotic patients compared to non-cirrhotics, cirrhosis had no impact on oncological outcomes and access/tolerance to postoperative chemotherapy. Thus cirrhosis should not be considered as a contraindication to curative treatment of colon cancer. (C) 2015 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.