Extended resection for locally advanced colorectal carcinoma

Curley, Steven A.; Carlson, Grant W.; Shumate, Charles R.; Wishnow, Kenneth I.; Ames, Frederick C.

doi:10.1016/0002-9610(92)90554-5

Cited by 93 publications

(60 citation statements)

References 25 publications

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“…The incidence of neoplastic infiltration is similar to result reported by Eisenberg et al [8], but it is higher than rates reported by others [4,6,7,[12][13][14][15][16][17]. This difference may result from the fact that more advanced tumors were treated in our hospital.…”

Section: Journal Of Surgical Oncologysupporting

confidence: 89%

“…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%

“…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]. Therefore, en bloc combined resections are obligatory in these cases to avoid tumor cell spillage by cutting into the tumorous mass [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Adjacent organ invasion is most frequently observed in sigmoid colon and rectal cancer, representing 66-89% of the cases [2,5,15]. This may be due to cancer predilection and redundancy of sigmoid colon.…”

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

“…In our series pT3 disease is quite similar with pT4 disease in terms of recurrence rate and recurrence pattern. It is worth emphasizing that tumor size alone in colorectal cancer is not a determinant of risk for regional lymph node metastases or of overall survival rate [15,23,24] and the presence of lymph node metastases is the most important pathologic determinant of survival [22,25]. The performance of a complete resection clearly influences survival time.…”

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

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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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Section: Journal Of Surgical Oncologysupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

See 3 more Smart Citations

Contiguous invasion per se does not affect prognosis in colon cancer

Kim

Paek

et al. 2008

Journal of Surgical Oncology

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Preoperative chemotherapy and radiation therapy for locally advanced primary and recurrent rectal carcinoma. A report of surgical morbidity

Shumate

Ota

Skibber

et al. 1993

Cancer

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Background. Complete surgical resection of locally advanced primary and recurrent rectal cancer is often incomplete. Improved tumor downstaging may improve resection rates and local control if postoperative morbidity is not increased. Methods. The clinical and pathologic records of 119 patients with locally advanced primary and recurrent rectal carcinoma were reviewed to determine the effect of preoperative chemoradiation on postoperative morbidity compared with a control group treated with external beam radiation therapy alone. Group I (56 patients) was treated with 45 Gy of external beam radiation therapy. Group II (63 patients) received 45 Gy of external beam radiation therapy with continuous‐infusion cisplatin, 5‐fluorouracil, or both. Results. Forty‐one patients (73.2%) in Group I and 48 in Group II (76.1%) underwent surgical resection. Anal‐sparing procedures were performed more frequently in Group II (25%) than in Group I (5.3%, P < 0.05). The overall complication rate for Group I was 51% versus 44% for Group II (P < 0.05) or 1.17 complications per patient in Group I and 0.58 complications per patient in Group II. One patient in each group died of treatment‐related septic complications. Conclusions. It was concluded that the addition of chemotherapy to radiation to treat rectal carcinoma does not result in an increased operative morbidity and may contribute to a higher proportion of patients being treated with anal–rectal‐conserving surgical procedures.

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The American Journal of Surgery

Polk

1992

Journal of British Surgery

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Extended resection for locally advanced colorectal carcinoma

Cited by 93 publications

References 25 publications

Contiguous invasion per se does not affect prognosis in colon cancer

Contiguous invasion per se does not affect prognosis in colon cancer

Preoperative chemotherapy and radiation therapy for locally advanced primary and recurrent rectal carcinoma. A report of surgical morbidity

The American Journal of Surgery

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