Gender-related differences in patients with colon cancer resection

In recent years, studies have revealed gender-related differences in many fields of medicine. Data on oncologic surgical patients show different pathologic, perioperative, and long-term outcomes between men and women with conflicting results. Very limited data are available on gender-related differences in colorectal cancer patients.

We analyzed a cohort of patients who had surgery for colon cancer at our center between 01/1990 and 12/2015. Clinical, pathological, perioperative, and long-term survival data were retrieved from a prospective database and gender-related differences were calculated for the overall cohort as well as for open and laparoscopic sub-cohorts.

In total, 1786 patients, 909 (50.9%) male, 877 (49.1%) female, were included. Women had clinical symptoms more often, but histopathologic and resection parameters as well as tumor location did not differ significantly between groups. The majority (n = 1609, 90.1%) underwent resection with anastomosis (male vs. female n.s.). Laparoscopic surgery was performed in 640 (35.8%, male vs. female n.s.). Men had a higher rate of anastomotic leakage (n = 50 [5.5%] vs. n = 30 [3.7%], p = 0.034). Other complications also occurred significantly more often in males. Analysis of open and laparoscopic surgery showed significant differences in complication rates only within the open group. The 5‑ and 10-year overall survival rates did not differ significantly.

Female and male patients encounter different rates of perioperative complications when undergoing surgery for colon cancer. In times where individualized treatment regimens are attempted to be established, future studies should take gender-related differences more into account. This study describes (1) gender-related differences in complication rates in the defined cohort of colon cancer patients, (2) higher rates of gender-related differences with regard to open versus laparoscopic procedures, and (3) equal long-term survival rates with regard to gender and laparoscopic versus open surgery.