Outcomes in Patients with Obstructive Jaundice from Metastatic Colorectal Cancer and Implications for Management

Shawnn D. Nichols, Scott Albert, Lawrence Shirley, Carl Schmidt, Sherif Abdel-Misih, Samer El-Dika, J. Royce Groce, Christina Wu, Richard M. Goldberg, Tanios Bekaii-Saab, Mark Bloomston

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Results: Sixty-two patients with metastatic colorectal cancer developed jaundice. Intrahepatic biliary obstruction was most common, occurring in younger patients. Time from metastatic diagnosis to presentation of jaundice was similar between groups, as was the mean number of prior lines of chemotherapy. Biliary decompression was successful 41.7 % of the time and was attempted more commonly for extrahepatic causes. Median overall survival after onset of jaundice was 1.5 months and it was similar between groups, but improved to 9.6 months in patients who were able to receive further chemotherapy.

Conclusions: Jaundice due to metastatic colorectal cancer is an ominous finding, representing aggressive tumor biology or exhaustion of therapies. Biliary decompression is often difficult and should only be pursued when additional treatment options are available.

Introduction: Patients with metastatic colorectal cancer can develop jaundice from intrahepatic or extrahepatic causes. Currently, there is little data on the underlying causes and overall survival after onset of jaundice. The purpose of this study was to characterize the causes of jaundice and determine outcomes.

Methods: Six hundred twenty-nine patients treated for metastatic colorectal cancer between 2004 and 2010 were retrospectively reviewed. Those developing jaundice were grouped as having intrahepatic or extrahepatic obstruction. Demographics, clinicopathologic, and outcome data were analyzed.

Original languageEnglish (US)
Pages (from-to)2186-2191
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume18
Issue number12
DOIs
StatePublished - Nov 18 2014

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Keywords

  • Biliary obstruction
  • Hepatic metastasis
  • Hyperbilirubinemia
  • Jaundice
  • Metastatic colorectal cancer

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Nichols, S. D., Albert, S., Shirley, L., Schmidt, C., Abdel-Misih, S., El-Dika, S., Groce, J. R., Wu, C., Goldberg, R. M., Bekaii-Saab, T., & Bloomston, M. (2014). Outcomes in Patients with Obstructive Jaundice from Metastatic Colorectal Cancer and Implications for Management. Journal of Gastrointestinal Surgery, 18(12), 2186-2191. https://doi.org/10.1007/s11605-014-2670-6