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Annals of Surgical Oncology

, Volume 20, Issue 9, pp 2929–2936 | Cite as

Multivisceral Resection in Colorectal Cancer: A Systematic Review

  • H. M. Mohan
  • M. D. Evans
  • J. O. Larkin
  • J. Beynon
  • D. C. Winter
Colorectal Cancer

Abstract

Background

The objective of this study was to critically evaluate current literature on outcomes following multivisceral resection (MVR) in colorectal cancer (CRC). Adequate surgical resection with clear margins is imperative in achieving long-term survival in colorectal cancer. Where there is adherence to or invasion of adjacent organs, (MVR) may be needed to achieve complete disease clearance.

Methods

A systematic review of MVR in CRC was performed. Pubmed/Medline and Cochrane databases were searched for English language articles from 1995 to 2012 using a predefined strategy. Retrieved abstracts were independently screened for relevance and data extracted from selected studies by 2 researchers. Results are reported as weighted means.

Results

Included were 22 studies comprising 1575 patients (87.0 % primary colorectal cancer; 13.0 % recurrent, 63.8 % rectal; 36.2 % colon). The most common organs resected were the bladder and reproductive organs. The perioperative mortality was 4.2 % with morbidity of 41.5 % (95 % CI, 40.8–42.2 %). The overall 5-year survival rate was 50.3 % (95 % CI, 49.9–50.8 %). Surgery for recurrence was associated with worse outcomes than primary tumors with 5-year survival 19.5 % (95 % CI, 17.8–21.1 %) for recurrent rectal cancer and primary rectal tumors 5-year overall survival 52.8 % (95 % CI, 52.0–53.8 %). R0 resection was the strongest factor associated with long-term survival.

Conclusions

Multivisceral resection provides the best possibility of long-term survival in locally advanced primary colorectal cancer in which a clear margin has been achieved.

Keywords

Colorectal Cancer Rectal Cancer Advanced Colorectal Cancer Pelvic Exenteration Primary Colorectal Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

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Supplementary material 1 (DOCX 18 kb)
10434_2013_2967_MOESM2_ESM.eps (695 kb)
Supplementary material 2 (EPS 694 kb)
10434_2013_2967_MOESM3_ESM.docx (354 kb)
Supplementary material 3 (DOCX 354 kb)

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • H. M. Mohan
    • 1
  • M. D. Evans
    • 2
  • J. O. Larkin
    • 1
  • J. Beynon
    • 2
  • D. C. Winter
    • 1
  1. 1.Department of SurgerySt. Vincent’s University HospitalDublinIreland
  2. 2.Department of Colorectal SurgerySingleton HospitalSwanseaUK

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