Long-term complications in colorectal cancer patients with urological resection – a multicentre study

Abstract Introduction Achieving resection-free margins is the most important predicting factor for long-term survival in advanced colorectal cancer (CRC) (1). This study investigates long-term complications in patients undergoing CRC surgery with concomitant urological resection. Method A retrospective cohort study was conducted at two tertiary centres in Sweden. Patients who underwent surgery for primary or recurrent CRC with concurrent resection of urinary organs between 2007-2020 were identified through the Swedish Colorectal Cancer Registry (SCRCR) and a local surgical database. Data collection is ongoing through SCRCR and review of local medical records recording complications up to five years postoperatively. Result We identified 269 patients: 108 (40%) rectal cancer and 161 (60%) colon cancer. All underwent open surgery, together with a urologist in187(69%) cases. Urological resections included total cystectomy (139/269, 52%), partial cystectomy (41/269, 35%) and ureter resection (30/269, 11 %). 45 (17%) had a reoperation within 30 days. Urological complications led to reoperation in 27 (10%) patients within 3 years, most often reimplantation of ureter (10/27, 37%). Resection free margins were obtained in 237 patients (88%), with an overall recurrence rate of 33% (89 patients) after 5 years. The overall 5-year survival rate was 62% (166 patients). Discussion Literature on long-term complications following urological resection in CRC are limited and inconclusive. This study in progress aims to provide valuable data on complications and outcomes in this high-risk patient group.