Comparison of Multivisceral Resection and Standard Operation for Locally Advanced Colorectal Cancer: Analysis of Prognostic Factors for Short-Term and Long-Term Outcome

Nakafusa, Yuji; Tanaka, Toshiya; Tanaka, Masayuki; Kitajima, Yoshihiko; Sato, Seiji; Miyazaki, Kohji

doi:10.1007/s10350-004-0716-7

Cited by 144 publications

(158 citation statements)

References 38 publications

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“…Nakafusa et.al. reported that the rate of ileus in the multivisceral resection group was significantly higher than that in the single organ resection group in addition to infectious complications (14). In our study, as two cases of ileus and seven cases of infectious complications were observed as postoperative complication, we need to take into account the occurrence of ileus and infectious complications probably due to the large dead space after multivisceral resection.…”

Section: Discussionmentioning

confidence: 77%

“…So, careful follow-up to diagnose early recurrence, especially within two years, would be required. As Nakafusa et al previously reported that only multivisceral resection was an independent factor for overall postoperative complications (14), extended en bloc multivisceral resection might involve serious complications, leading to an increase in morbidity and mortality. In previous reports, postoperative morbidity and mortality rates after mutivisceral resection tend to be higher ranging from 28.0 to 43.7% (2,8,12,(15)(16)(17) and ≥13% (5,7,12,18), respectively.…”

Section: Discussionmentioning

confidence: 94%

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Multivisceral resections for locally advanced colorectal cancer after preoperative treatment

et al. 2018

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Abstract. Multivisceral resection for colorectal cancer invading into the adjacent organs may often be difficult and may involve serious complications. Preoperative therapy may facilitate resection with safe margins. Between August 2007 and July 2016, 23 patients with colorectal cancer invading into the adjacent organs treated with preoperative treatment (chemoradiotherpay, chemotherapy, radiotherapy) were retrospectively investigated. All 23 patients received surgery with curative intent. Four patients had distant metastases at the time of diagnosis. Two patients had distant metastasis after preoperative treatment. The mean operative time was 535.3±185.5 min and the median amount of blood loss was 1,050 ml. Histopathological examination revealed malignant infiltration of the adjacent organs in 14 patients (60.9%). R0 resection rate was 73.9%. Postoperative complications were identified in nine patients (39.1%) and a high incidence of infectious complications was observed. Patients with curative resection showed a significantly better survival than patients with R1 or R2 resection (P<0.01). Multivisceral resection for locally advanced colorectal cancer invading into the adjacent organ after preoperative treatment may be performed with acceptable morbidity and minimal mortality. R0 resection improves the prognosis of patients with locally advanced colorectal cancer invading into the adjacent organ after preoperative treatment.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 94%

Multivisceral resections for locally advanced colorectal cancer after preoperative treatment

et al. 2018

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“…Os principais fatores que pioram o prognóstico das ressecções alargadas são comprometimento linfonodal, transfusão sanguínea e violação do tumor. Embora a morbidade pós-operatória seja maior que a cirurgia convencional, a abordagem em monobloco reduz a incidência de sangramento e contribui para melhores resultados, apresentando índices de recidiva local, tempo livre de doença e sobrevida global semelhantes aos casos que não requerem ressecção multivisceral 7,16 .…”

Section: Discussionunclassified

Ressecção alargada para o adenocarcinoma colorretal localmente invasivo: relato de caso e revisão da literatura

Horta

Wolf

Balsamo

et al. 2009

Rev bras. colo-proctol.

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RESUMO: O câncer colorretal localmente invasivo, que acomete por contiguidade estruturas adjacentes e sem metástases à distância, ocorre de 5 a 18% dos casos. São adequadamente tratados com ressecção do tumor e órgãos comprometidos em monobloco e margens livres. É relatado o caso de paciente de 27 anos, masculino, portador de adenocarcinoma de retossigmóide com extensa invasão para bexiga e ceco. Tratado com colectomia total, cistectomia radical em monobloco e ileostomia. O trânsito urinário foi reconstituído com reservatório ileal e anastomose com a uretra prostática. O estudo anátomo-patológico da peça cirúrgica revelou adenocarcinoma moderadamente diferenciado, invasão perineural e invasão da parede da bexiga (T4, N0). Realizou no pós-operatório quimioterapia adjuvante, 6 ciclos, com 5-Fluorouracil e ácido folínico. Após 36 meses de seguimento, o paciente encontra-se livre de doença neoplásica, função urinária preservada, porém com ejaculação retrógrada. Descritores INTRODUÇÃOO câncer colorretal (CCR) é a quarta neoplasia maligna mais comum e a segunda causa de morte por câncer nos EUA¹. No Brasil é o quinto mais diagnosticado, sendo a quarta causa de morte por câncer, além de ser o mais frequente do tubo digestivo. O tipo histológico predominante é o adenocarcinoma². A sobrevida global em cinco anos de pacientes submetidos ao tratamento cirúrgico está em torno de 50% ³. O CCR localmente invasivo (T4, TNM/AJCC) 4 , o qual acomete órgãos adjacentes por contiguidade, na ausência de metástases à distância, ocorre em aproximadamente 10% dos casos, sendo os sítios primários mais comuns o cólon sigmóide e o reto 5 . Nestes casos é necessário a ressecção do tumor e das estruturas acometidas em monobloco, pois esta é a única opção terapêutica que pode oferecer a cura [6][7][8] . Os órgãos mais comumente invadidos são a bexiga, intestino delgado, útero, ovários/trompas e vagina 9 .O objetivo deste trabalho é relatar um caso de adenocarcinoma da transição retossigmoide com extensa invasão para a bexiga e ceco, em paciente jovem, tratado com ressecção alargada, multivisceral e em monobloco. RELATO DO CASOWHB, 27 anos, masculino, há três meses com perda de peso e inapetência. Alteração do hábito intes-

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“…Reportedly, histologic tumor infiltration is demonstrated in 39-84% of cases in which the tumor is found to be adherent to the adjacent viscera whereas the rest represent inflammatory adherence [4,[6][7][8][12][13][14][15][16][17]. Any attempt to separate the carcinoma from adherent organs may lead to tearing or transection of the tumor with the risk of intraoperative dissemination of tumor cells, resulting in early local recurrence [1,4,6,15].…”

Section: Discussionmentioning

confidence: 99%

“…Recent study confirmed that T4 stage is an important independent prognostic factor [11]. On the contrary, many investigators have reported the feasibility of the en bloc resection [4,6,7,12] and some have shown a fairly good long-term prognosis [13,14]. However, there were few studies investigating the prognostic significance of tumor invasion to adjacent organs after en bloc resection in locally advanced colon cancer.…”

Section: Introductionmentioning

confidence: 99%

Contiguous invasion per se does not affect prognosis in colon cancer

Kim

Paek

et al. 2008

Journal of Surgical Oncology

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Background: Locally advanced colon cancer can result in serious clinical conditions unless treated appropriately. The aim of this study was to examine the feasibility of en bloc resection and the significance of depth of invasion by analyzing the outcomes of the procedure in colon cancer invading adjacent organs. Methods: Outcomes of 65 locally advanced colon cancer patients who underwent en bloc resections for contiguous invasion were compared with 285 pT3 colon cancer patients. Results: En bloc combined resection was performed in 75 patients and 10 (13.3%) of them showed no true malignant infiltration into adjacent organs. In both pT3 and pT4 groups, there was no significant difference in major postoperative complications or mortality. The survival rate of pT4 group was similar to that of pT3 group (5-year rate, 64.0% vs. 72.7%; P ¼ 0.287). In multivariate analysis, lymph node metastasis, lymphovascular infiltration, and perineural invasion were independently associated with patient survival. Conclusions: The prognosis of colon cancer, even in locally advanced cases, is mainly correlated with nodal status rather than depth of invasion. Therefore, en bloc combined resection in locally advanced colon cancer invading adjacent organs can improve survival as well as local control with acceptable morbidity and mortality.

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Comparison of Multivisceral Resection and Standard Operation for Locally Advanced Colorectal Cancer: Analysis of Prognostic Factors for Short-Term and Long-Term Outcome

Cited by 144 publications

References 38 publications

Multivisceral resections for locally advanced colorectal cancer after preoperative treatment

Multivisceral resections for locally advanced colorectal cancer after preoperative treatment

Ressecção alargada para o adenocarcinoma colorretal localmente invasivo: relato de caso e revisão da literatura

Contiguous invasion per se does not affect prognosis in colon cancer

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