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Survival after urological resections in colorectal cancer : a Swedish nationwide study

Assi, Hanin LU ; Valdimarsson, Valentinus LU orcid ; Angenete, Eva ; Buchwald, Pamela LU and Lydrup, Marie-Louise LU (2026) In European Journal of Surgical Oncology 51(8). p.1-7
Abstract
Background
Colorectal cancer with overgrowth into urinary organs requires en-bloc resection of involved organs to achieve negative resection margins (R0). This study investigates survival and oncological outcomes after colorectal cancer surgery with resections of urinary organs.
Method
Patients undergoing colorectal cancer surgery with urological resection in Sweden 2007–2018 were identified via the Swedish Colorectal Cancer Registry using the variable “resection of another organ”.
Results
A total of 57 907 patients underwent colorectal cancer resection, and 1093 patients had concomitant urological resections: 589 total cystectomies, 345 partial cystectomies, and 159 ureteral resections. The majority undergoing total or... (More)
Background
Colorectal cancer with overgrowth into urinary organs requires en-bloc resection of involved organs to achieve negative resection margins (R0). This study investigates survival and oncological outcomes after colorectal cancer surgery with resections of urinary organs.
Method
Patients undergoing colorectal cancer surgery with urological resection in Sweden 2007–2018 were identified via the Swedish Colorectal Cancer Registry using the variable “resection of another organ”.
Results
A total of 57 907 patients underwent colorectal cancer resection, and 1093 patients had concomitant urological resections: 589 total cystectomies, 345 partial cystectomies, and 159 ureteral resections. The majority undergoing total or partial cystectomy were men (442 (75 %) and 271 (63 %), respectively).
R0 was obtained in 509/589 patients (86 %), 296/345 patients (86 %), and 134/169 patients (84 %) for total cystectomy, partial cystectomy, and ureteral resection, respectively. Five-year overall survival rates were 361 patients (61 %) after total cystectomy, 201 patients (58 %) after partial cystectomy, and 85 patients (53 %) after ureteral resection (Kaplan–Meier, Log-rank test p = 0.205). Multivariable analyses adjusted for sex, age, ASA classification, tumour localisation (colon/rectum), cTNM, pTN, year of surgery, and type of surgery (emergency/elective) revealed higher local recurrence rate in the ureteral resection group (hazard ratio: 2.290, 95 % CI: 1.166–4.498), while 5-year overall survival and distant metastases rates did not differ.
Conclusion
Partial cystectomy may represent an option to total cystectomy in selected patients with colorectal cancer overgrowth on urinary organs while maintaining favourable survival and oncological outcomes. Still, selection bias is an inherent problem in the interpretation of results. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Surgical Oncology
volume
51
issue
8
article number
110078
pages
1 - 7
publisher
Elsevier
external identifiers
  • pmid:40393336
  • scopus:105005102090
ISSN
1532-2157
DOI
10.1016/j.ejso.2025.110078
language
English
LU publication?
yes
id
4cfc1148-559f-42b2-830e-faddccd5e8bc
date added to LUP
2026-04-30 11:56:49
date last changed
2026-05-01 04:00:58
@article{4cfc1148-559f-42b2-830e-faddccd5e8bc,
  abstract     = {{Background<br/>Colorectal cancer with overgrowth into urinary organs requires en-bloc resection of involved organs to achieve negative resection margins (R0). This study investigates survival and oncological outcomes after colorectal cancer surgery with resections of urinary organs.<br/>Method<br/>Patients undergoing colorectal cancer surgery with urological resection in Sweden 2007–2018 were identified via the Swedish Colorectal Cancer Registry using the variable “resection of another organ”.<br/>Results<br/>A total of 57 907 patients underwent colorectal cancer resection, and 1093 patients had concomitant urological resections: 589 total cystectomies, 345 partial cystectomies, and 159 ureteral resections. The majority undergoing total or partial cystectomy were men (442 (75 %) and 271 (63 %), respectively).<br/>R0 was obtained in 509/589 patients (86 %), 296/345 patients (86 %), and 134/169 patients (84 %) for total cystectomy, partial cystectomy, and ureteral resection, respectively. Five-year overall survival rates were 361 patients (61 %) after total cystectomy, 201 patients (58 %) after partial cystectomy, and 85 patients (53 %) after ureteral resection (Kaplan–Meier, Log-rank test p = 0.205). Multivariable analyses adjusted for sex, age, ASA classification, tumour localisation (colon/rectum), cTNM, pTN, year of surgery, and type of surgery (emergency/elective) revealed higher local recurrence rate in the ureteral resection group (hazard ratio: 2.290, 95 % CI: 1.166–4.498), while 5-year overall survival and distant metastases rates did not differ.<br/>Conclusion<br/>Partial cystectomy may represent an option to total cystectomy in selected patients with colorectal cancer overgrowth on urinary organs while maintaining favourable survival and oncological outcomes. Still, selection bias is an inherent problem in the interpretation of results.}},
  author       = {{Assi, Hanin and Valdimarsson, Valentinus and Angenete, Eva and Buchwald, Pamela and Lydrup, Marie-Louise}},
  issn         = {{1532-2157}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1--7}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Surgical Oncology}},
  title        = {{Survival after urological resections in colorectal cancer : a Swedish nationwide study}},
  url          = {{http://dx.doi.org/10.1016/j.ejso.2025.110078}},
  doi          = {{10.1016/j.ejso.2025.110078}},
  volume       = {{51}},
  year         = {{2026}},
}