Scientific paper
En bloc resection of colon cancer adherent to other organs

https://doi.org/10.1016/0002-9610(87)90292-3Get rights and content

Abstract

This study was undertaken to determine the optimal surgical treatment of colorectal cancers with adherence to adjacent organs in the absence of distant metastases. A retrospective review of colorectal cancer at Virginia Mason Hospital from 1975 to 1979 divided patients with Dukes' stage B2 and C2 colorectal cancers into three treatment groups: standard colectomy, en bloc resection, and colectomy with separation of adherent organs, with 5 year survival rates of 55 percent, 61 percent, and 23 percent, respectively. No operative mortality occurred with en bloc resection. Survival after en bloc resection was influenced by Dukes' stage and the histologic documentation of cancer within the adherent organ. Unacceptably high local recurrence rates and poor 5 year survival rates were observed in cases where adherent organs were separated from the colorectal cancer. We conclude that colorectal cancer adherent to other organs should be treated by en bloc resection. The survival rate after en bloc resection will be comparable to the rate after standard colectomy for nonadherent colorectal cancers.

References (13)

  • B Moynihan
  • GG Turner

    Cancer of the colon

    Lancet

    (1929)
  • ED Sugarbaker

    Coincident removal of additional structures in resections for carcinoma of the colon and rectum

    Ann Surg

    (1946)
  • VB Astler et al.

    Prognostic significance of direct extension of carcinoma of the colon and rectum

    Ann Surg

    (1954)
  • J Van Prohaska et al.

    Multiple organ resection for advanced carcinoma of the colon and rectum

    Surg Gynecol Obstet

    (1953)
  • HE Jensen et al.

    Extensive surgery in the treatment of carcinoma of the colon

    Acta Chir Scand

    (1970)
There are more references available in the full text version of this article.

Cited by (135)

  • Locally advanced primary recto-sigmoid cancers: Improved survival with multivisceral resection

    2017, American Journal of Surgery
    Citation Excerpt :

    Additionally we have demonstrated that our findings reinforce the benefit of radiation therapy in rectal cancers and this is seen by the survival benefit in all subgroups. This findings is in keeping with the NCCN recommendation for radiation therapy for advanced colon and rectal cancer.8 Current National Comprehensive Cancer Network (NCCN) guidelines for radiation therapy in colon cancer recommend that radiation therapy be used for close or positive margins and in tumors that have extended beyond the serosa, T4 lesions, as well as, with concurrent chemotherapy (5FU) to aid in respectability.

View all citing articles on Scopus

Presented at the 58th Annual Meeting of the Pacific Coast Surgical Association, Rancho Mirage, California, February 15–18, 1987.

1

From the Section of General Surgery, Virginia Mason Medical Center, Seattle, Washington.

View full text