JL: Study conception and design, acquisition of data, GDC-0449 chemical structure analysis and interpretation of data, drafting of manuscript. SF: Acquisition of data, analysis and interpretation of data, drafting of manuscript. MH: Study conception and design, analysis and interpretation of data, drafting of manuscript. FH: Study conception and design, analysis and interpretation of data, critical revision. EV: Analysis and interpretation of data, critical revision of manuscript. LL: Study conception and design, critical revision of manuscript. All authors have given

final approval for this manuscript to be published.”
“Introduction CX-5461 in vitro colorectal cancer (CRC) is one of the common cancers in which surgery plays a crucial Raf inhibitor role in the definitive management. When a diagnosis of CRC is suspected, it is recommended by the UK National Health Service that the patient should be referred within 2 weeks [1] and treatment should be performed within one month of diagnosis [2]. However, due to resource constraints, this quick response is often impossible [3], resulting in 15-30% of CRC cases require emergency surgery due to development of acute symptoms while they await their surgery [4]. Identifying CRC patients who are likely to develop acute conditions in order to have the option of considering

fast-track service could reduce problems associated with prolonged waits for necessary surgeries. Unplanned operations in patients with colorectal cancer are associated with a higher incidence of operative complications and poorer

surgical outcome than non-emergency procedures [4–6], and the most common condition that leads to emergency surgery in these patients is colonic obstruction [7]. CRC patients that are at risk of cAMP needing emergency surgery should, therefore, be prioritized. However, the clinical presentation of CRC patients is not always correlated with the severity of obstruction, this making the scheduling of prioritized surgeries a hit-and-miss decision at best. In this study, we aimed to look for a correlation between an endoscopic finding of tumor obstruction and the risk of needing emergency surgery in CRCs. Methods Histologically proven colorectal adenocarcinoma patients recorded in the Cancer Registry Unit of Songklanagarind Hospital who were operated on at the institute during the period between the years 2002 and 2011 and who had a colonoscopy before their operation were included in this retrospective review. The data were retrieved from electronic medical records and reviewed regarding clinical and pathological parameters with an emphasis on the management timeline.