Objective: We reported the analysis of long and short-term treatment outcomes of pa-tients with bowel perforation caused by obstructive colorectal cancer. Summary of Background Date: From April 2003 to March 2013, 15 patients with bowel perforation caused by obstructive colorectal cancer underwent emergent surgery in our hospital. Methods: Clinical outcomes were retrospectively analyzed by age, gender, tumor loca-tion, time to surgery from diagnosis, operative method, stage, postoperative complication, and preoperative severity score by APACHE II scoring system. We studied outcome of short-term outcomes and long-term prognosis used by overall survival. Results: The median age was 67.6 years. Male to female ratio was 10:5. The mortality rate was 20% and the median of APACHE II score was 15. The survival cases (n=11) showed significantly lower APACHE II score compared with fatal cases (n=4) (p=0.02). The median overall survival was 18.9 months in survival cases except for stage IV case. 5 patients had recurrence and distant metastasis (50%). Conclusion: The APACHE II score may be an useful predictive marker for short-term outcome and determining operative method in patient with perforation caused by obstructive colorectal cancer. It is necessary to consider that perforation is high risk factor for recurrence and the most of recurrence pattern is peritoneum dissemination.

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