Concomitant adjacent organ resection in locally advanced colon cancer

Abstract

Purpose: In locally advanced adherent colon cancer surgery, a mutivisceral resection is known to reduce local recurrence and improve survival. Practically, the benefit of using this procedure may outweigh the risk of associated morbidity, but the procedure may not be performed uniformly. We reviewed the results of multivisceral resections for locally advanced colon cancer. Methods: From 2003 January to 2008 January, 476 colon cancer patients underwent surgery for locally advanced colon cancer in our hospital. Out of the 476 patients, 36 patients with pT3-pT4 who underwent any kind of adjacent organ resection other than a resection of the colon were reviewed retrospectively. Results: Out of the 36 patients, 22 were male and 14 were female, and the mean age was 63.44 ± 13.26 yr. The sigmoid colon was the most common location for the primary lesion, followed by the ascending colon, the transverse colon, and the cecum. Invaded organs were the abdominal or pelvic wall in 5 patients, the visceral organs in 26 patients, the retroperitoneum in 2 patients. All patients received an en-bloc resection of the invaded organs. Ten patients were stage II, 14 patients were stage III, and 12 patients were stage IV. Fifteen patients were disease free at the end of this study, local recurrence had occurred in 1 patient, 6 patients had an intraabdominal recurrence, and 2 patients had developed a distant metastasis. The overall complication rate was 28%. The 5-yr survival rate of each stage according to the surgical approach did not show any meaningful difference. Conclusion: A multivisceral en-bloc resection has been recommended for locally advanced adherent colon cancer patients. To improve the outcome, we suggest progressive surgical treatment in such patients. © 2009 The Korean Society of Coloproctology.