Algorithm for surgical treatment of patients with metastatic colorectal cancer complicated by intestinal obstruction

Aim: to develop an algorithm for selecting the optimal surgical intervention for patients with metastatic colorectal cancer complicated by obstructive intestinal obstruction. Material and methods. The study is based on an analysis of the treatment outcomes of 202 patients with metastatic colorectal cancer complicated by obstructive intestinal obstruction. The patients were divided into two groups. Group 1 included 119 patients who underwent primary tumor removal as the first stage. Group 2 included 83 patients who underwent only symptomatic drainage surgery to relieve intestinal obstruction. Results. The one-year mortality rate was 37 patients (31.1%) in Group 1 and 51 (61.4%) in Group 2. Multivariate analysis identified predictors influencing the one-year mortality rate: the number of internal organs affected by metastases, albumin/globulin ratio, Krebs index, MCV index, and the planned targeted therapy regimen. Conclusion. Based on this analysis, a step-by-step decision-making algorithm was developed to determine the indications for primary tumor removal, and a computer program was created to calculate the one-year mortality risk in patients with metastatic colorectal cancer.