Outcomes, safety and staging of multivisceral resection for locally advanced primary colorectal cancer
Dae Ro Lim, Jung Cheol Kuk, Taehyung Kim, Eung Jin Shin
Abstract
Background
Multivisceral resection is often required in the treatment of locally advanced colorectal cancer.
Aims
The present study provides an analysis of the perioperative and oncological outcomes of multivisceral resection for locally advanced primary colorectal cancer.
Methods
Between January 2001 and December 2013, 58 patients who underwent multivisceral resection for locally advanced colorectal cancers were retrieved from a prospective database. 22 patients met the criterion of confirmed positivity of invasion or metastasis in pathologic findings after surgery (Group I) and 36 patients met the criterion of just adhesion at a nearby organ without confirmed positivity of invasion or metastasis after surgery (Group II). They were compared with respect to patient demographics, peri- and postoperative morbidity, and pathologic and oncological outcomes.
Results
The actual distribution of stage was pathologically reported as follows: IIa (n=21, 58.3 per cent), IIb (n=2, 5.5 per cent), IIIb (n=9, 25.0 per cent), and IIIc (n=4, 11.2 per cent) in Group II (initial clinical T4bNxM0) and IVa (n=21, 95.5 per cent), (n=1, 4.5 per cent) in Group I. With a median follow-up of 47.7 months, the five-year overall survival rate for Group I and Group II was 38.0 per cent and 62.9 per cent, respectively (p=0.100). The five-year disease free survival rate was 36.8 per cent (Group I) versus 61.9 per cent (Group II) (p=0.200).The local recurrence rate was 4.5 per cent (Group I) versus 5.6 per cent (Group II) (p=0.278). The mean length of patients’ hospital stay was 18.1 days and 15.9 days (p=0.049). The rate of morbidity was 10.3 per cent in Group I and 28.4 per cent in Group II (p=0.204).
Conclusion
Based on the present data, multivisceral resection for locally advanced colorectal cancer (clinically T4b) has acceptable perioperative and oncologic outcomes and may be a feasible procedure.
Full Text:
Multivisceral resection is often required in the treatment of locally advanced colorectal cancer.
Aims
The present study provides an analysis of the perioperative and oncological outcomes of multivisceral resection for locally advanced primary colorectal cancer.
Methods
Between January 2001 and December 2013, 58 patients who underwent multivisceral resection for locally advanced colorectal cancers were retrieved from a prospective database. 22 patients met the criterion of confirmed positivity of invasion or metastasis in pathologic findings after surgery (Group I) and 36 patients met the criterion of just adhesion at a nearby organ without confirmed positivity of invasion or metastasis after surgery (Group II). They were compared with respect to patient demographics, peri- and postoperative morbidity, and pathologic and oncological outcomes.
Results
The actual distribution of stage was pathologically reported as follows: IIa (n=21, 58.3 per cent), IIb (n=2, 5.5 per cent), IIIb (n=9, 25.0 per cent), and IIIc (n=4, 11.2 per cent) in Group II (initial clinical T4bNxM0) and IVa (n=21, 95.5 per cent), (n=1, 4.5 per cent) in Group I. With a median follow-up of 47.7 months, the five-year overall survival rate for Group I and Group II was 38.0 per cent and 62.9 per cent, respectively (p=0.100). The five-year disease free survival rate was 36.8 per cent (Group I) versus 61.9 per cent (Group II) (p=0.200).The local recurrence rate was 4.5 per cent (Group I) versus 5.6 per cent (Group II) (p=0.278). The mean length of patients’ hospital stay was 18.1 days and 15.9 days (p=0.049). The rate of morbidity was 10.3 per cent in Group I and 28.4 per cent in Group II (p=0.204).
Conclusion
Based on the present data, multivisceral resection for locally advanced colorectal cancer (clinically T4b) has acceptable perioperative and oncologic outcomes and may be a feasible procedure.
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