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Extended resection for locally advanced colorectal carcinoma

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Abstract

Background: The purpose of this study was to determine the therapeutic benefit of multivisceral resection (MVR) in patients with locally advanced colorectal carcinomas.

Methods: The study population was composed of 118 patients whose resection of the primary lesion included one or more adhesed adjacent secondary organs or structures (ASOS). Tumors were staged as B3 (T4,N0) and as C3 (T4,N1–3). Adhesions were classified as invasive (B3+,C3+) or inflammatory (B3−,C3−).

Results: Sixty-four patients were staged B3 and 54 C3. Eighty-one were classified B3+/C3+. Fifty-nine percent of patients had ASOS resected, 29% had two resected, and the remaining 12% had three or four resected. Actuarial 5-year survival rates were 62% and 38% (p=0.017) for B3 and C3 lesions, respectively. The 5-year survival rates were 78% for patients with B3− tumors and 58% for those with B3+ tumors (p=0.043), and 34% for patients with C3+ tumors and 64% for those with C3− tumors (p=NS). The 5-year survival rates were 71% for patients with B3−/C3− tumors and 47% for those with B3+/C3+ tumors (p=NS). The 5-year survival rates after resection of one ASOS, two ASOS, and three or four ASOS were 52%, 55%, and 38%, respectively (p=NS).

Conclusion: There is no statistically significant difference in the 5-year survival rates when multiple ASOS are resected; therefore, an aggressive surgical approach is warranted.

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References

  1. A cancer journal for clinicians.Cancer Stat 1995;45:12.

  2. Polk HC Jr. extended resection for selected adenocarcinomas of the large bowel.Ann Surg 1972;175:892–9.

    PubMed  Google Scholar 

  3. Jensen J-E, Balslev I, Neilsen J. Extensive surgery in treatment of carcinoma of the colon.Acta Chir Scand 1970;136:431–4.

    CAS  PubMed  Google Scholar 

  4. Davis CG, Ellis H. Radical surgery in locally advanced cancer of the large bowel.Clin Oncol 1975;1:21–6.

    Google Scholar 

  5. Eisenberg SB, Kraybill WG, Lopez MJ. Long-term results of surgical resection of locally advanced colorectal carcinoma.Surgery 1990;108:779–86.

    CAS  PubMed  Google Scholar 

  6. Eldar S, Kemeny MM, Terz JJ. Extended resections for carcinoma of the colon and rectum.Surg Gynecol Obstet 1985;161:319–22.

    CAS  PubMed  Google Scholar 

  7. Heslov SF, Frost DB. Extended resection for primary colorectal carcinoma involving adjacent organs or structures.Cancer 1988;62:1637–40.

    CAS  PubMed  Google Scholar 

  8. Gall FP, Tonak J, Altendorf A. Multivisceral resections in colorectal cancer.Dis Colon Rectum 1987;30:337–41.

    CAS  PubMed  Google Scholar 

  9. McGlone TP, Bernie WA, Elliot DW. Survivl following extended operations for extracolonic invasion by colon cancer.Arch Surg 1982;117:595–9.

    CAS  PubMed  Google Scholar 

  10. Lopez MJ, Monafo WW. Role of extended resection in the initial treatment of locally advanced colorectal carcinoma.Surgery 1993;113:365–72.

    CAS  PubMed  Google Scholar 

  11. Kelley WE Jr, Brown PW, Lawrence W Jr, Terz JJ. Penetrating, obstructing, and perforating carcinomas of the colon and rectum.Arch Surg 1981;116:381–4.

    PubMed  Google Scholar 

  12. Hunter J, Ryan JA Jr, Schultz P. En bloc resection of colon cancer adherent to other organs.Am J Surg 1987;15467–70.

  13. Sugarbaker ED. Coincident removal of additional structures in resections for carcinoma of the colon and rectum.Ann Surg 1946;123:1036–46.

    Google Scholar 

  14. Gunderson L, Sosin H. Areas of failure found at reoperation following curative surgery for adenocarcinoma of the rectum.Cancer 1971;31:1278–92.

    Google Scholar 

  15. Staniunas RJ, Schoetz DJ Jr. Extended resection for carcinoma of colon and rectum.Surg Clin North Am 1993;73:117–29.

    CAS  PubMed  Google Scholar 

  16. Moynihan B.Abdominal operations. Philadelphia: WB Saunders, 1926:19.

    Google Scholar 

  17. Spratt JS Jr, Watson FR, Pratt Jl. Characteristics of a variant of colorectal carcinoma that does not metastasize to lymph nodes.Dis Colon Rectum 1970;13:243–6.

    PubMed  Google Scholar 

  18. Pittam MR, Thornton H, Illis H. Survival after extended resection for locally advanced carcinomas of the colon and rectum.Ann R Coll Surg Engl 1984;66:81–4.

    CAS  PubMed  Google Scholar 

  19. Bonfanti G, Bozzetti F, Doci R, et al. Results of extended surgery for cancer of the rectum and sigmoid.Br J Surg 1982;69:305–7.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. the Department of Surgery, Division of Surgical Oncology, Kaiser Permanente Medical Group, Los Angeles, California, USA

    Vincent L. Rowe MD & Samuel Huang MD

  2. Department of Radiation Oncology, Kaiser Permanente Medical Group, 4950 Sunset Blvd., 90027, Los Angeles, CA, USA

    Daniel B. Frost MD (FACS)

Authors
  1. Vincent L. Rowe MD
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  2. Daniel B. Frost MD
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  3. Samuel Huang MD
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Rowe, V.L., Frost, D.B. & Huang, S. Extended resection for locally advanced colorectal carcinoma. Annals of Surgical Oncology 4, 131–136 (1997). https://doi.org/10.1007/BF02303795

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  • DOI: https://doi.org/10.1007/BF02303795

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