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Aim <p>In this study, we aimed to evaluate the pathological oncological adequacy of emergency colon cancer surgery by comparing surgical margin status, lymph node yield, lymph node ratio, TNM staging parameters, tumor localization, surgical procedure, and stoma formation between emergency and elective colon cancer resections.</p> Methods <p>In this retrospective study, 174 patients who underwent curative colon cancer surgery between 2012 and 2018 were analyzed. Patients were divided into emergency (n=80) and elective (n=94) groups. Pathological oncological adequacy was assessed using lymph node yield, number of metastatic lymph nodes, lymph node ratio, proximal and distal surgical margins, and TNM staging. Surgical procedure, stoma formation, tumor localization, and available emergency-presentation characteristics were also evaluated. Statistical analyses included the Mann-Whitney U test, chi-square test, Kruskal-Wallis test, and two-way ANOVA.</p> Results <p>There were no significant differences between the groups in lymph node yield (p=0.73), number of metastatic lymph nodes (p=0.42), lymph node ratio (p=0.52), or surgical margin distance. Tumor invasion depth (T stage) was significantly more advanced in the emergency group (p=0.004). Tumor localization independently influenced lymph node yield, with left-sided tumors associated with lower lymph node counts regardless of surgical urgency. Stoma formation was significantly more frequent in emergency cases (p&lt;0.001). From a perioperative perspective, stoma formation was used as the consistently available operative variable reflecting emergency-related surgical decision-making. The emergency group had a substantially higher end-stoma rate than the elective group (33/80, 41.3% vs. 2/94, 2.1%). Detailed intraoperative events and postoperative complications were not consistently recorded in a standardized manner across the study period; therefore, complication type and severity could not be compared quantitatively between groups. Despite this limitation, pathological oncological indicators, including lymph node yield, margin distance, metastatic lymph node count, and lymph node ratio, remained comparable between emergency and elective resections.</p> Conclusion <p>Emergency colon cancer surgery did not compromise pathological indicators of oncological adequacy, including lymph node yield and surgical margin status, when compared with elective surgery. Emergency cases had more advanced tumor invasion and required stoma formation more frequently. Because detailed standardized complication grading and long-term survival outcomes were not consistently available, the findings should be interpreted as comparable pathological oncological adequacy rather than definitive long-term oncological equivalence.</p>

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Emergency Colon Cancer Surgery Does Not Compromise Pathological Oncological Adequacy: A Comparative Analysis of Elective and Emergency Resections

  • 期刊论文

  • 发表日期：

    2026年7月20日

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  • Samed Sayar,
  • Ufuk Mete Yıldız,
  • Ahmet Serkan İlgün,
  • İklil Eryılmaz,
  • Muhammed Özdemir,
  • Özgecan Gundogar,
  • Doğan Gönüllü,
  • Ferda Nihat Köksoy

摘要

Aim

In this study, we aimed to evaluate the pathological oncological adequacy of emergency colon cancer surgery by comparing surgical margin status, lymph node yield, lymph node ratio, TNM staging parameters, tumor localization, surgical procedure, and stoma formation between emergency and elective colon cancer resections.

Methods

In this retrospective study, 174 patients who underwent curative colon cancer surgery between 2012 and 2018 were analyzed. Patients were divided into emergency (n=80) and elective (n=94) groups. Pathological oncological adequacy was assessed using lymph node yield, number of metastatic lymph nodes, lymph node ratio, proximal and distal surgical margins, and TNM staging. Surgical procedure, stoma formation, tumor localization, and available emergency-presentation characteristics were also evaluated. Statistical analyses included the Mann-Whitney U test, chi-square test, Kruskal-Wallis test, and two-way ANOVA.

Results

There were no significant differences between the groups in lymph node yield (p=0.73), number of metastatic lymph nodes (p=0.42), lymph node ratio (p=0.52), or surgical margin distance. Tumor invasion depth (T stage) was significantly more advanced in the emergency group (p=0.004). Tumor localization independently influenced lymph node yield, with left-sided tumors associated with lower lymph node counts regardless of surgical urgency. Stoma formation was significantly more frequent in emergency cases (p<0.001). From a perioperative perspective, stoma formation was used as the consistently available operative variable reflecting emergency-related surgical decision-making. The emergency group had a substantially higher end-stoma rate than the elective group (33/80, 41.3% vs. 2/94, 2.1%). Detailed intraoperative events and postoperative complications were not consistently recorded in a standardized manner across the study period; therefore, complication type and severity could not be compared quantitatively between groups. Despite this limitation, pathological oncological indicators, including lymph node yield, margin distance, metastatic lymph node count, and lymph node ratio, remained comparable between emergency and elective resections.

Conclusion

Emergency colon cancer surgery did not compromise pathological indicators of oncological adequacy, including lymph node yield and surgical margin status, when compared with elective surgery. Emergency cases had more advanced tumor invasion and required stoma formation more frequently. Because detailed standardized complication grading and long-term survival outcomes were not consistently available, the findings should be interpreted as comparable pathological oncological adequacy rather than definitive long-term oncological equivalence.