A Study of Non-resection Cases of Colorectal Cancer without Distant Metastasis

Abstract

Aim: The present study clarified the treatment policy decisions and outcomes and examined the problems in patients with colorectal cancer without distant metastasis who did not undergo radical surgery.

Methods: We enrolled 348 patients diagnosed with primary colorectal cancer between April 2016 and March 2021. We retrospectively investigated the clinical background of 32 patients who were not resected, excluding those with cStage IV disease.

Results: The median age was 89 (range: 70-98) years old. The median prognostic nutrition index was 36.9, the modified Glasgow prognostic score was 1.5, and the Charlson comorbidity index was 4; these findings indicate that the patients without resection had a poor nutritional status and many comorbidities. Eleven cases with obstructive symptoms underwent palliative surgery. The main reasons for non-resection were older age and the presence of comorbidities, such as dementia, such that 18 patients (56.3%) were unable to make a decision regarding resection. Deaths from other diseases were more common than tumor-related deaths.

Conclusion: There was a tendency to refrain from treatment due to advanced tumors, comorbidities, and poor social background. To ensure adequate decision-making, individual judgment is required, and it is necessary to treat patients while keeping these findings in mind.