Operative treatment of colorectal cancer

Abstract

Principles of radical surgery for curative treatment of colon and rectal cancer are based on 5‐year survival and 2‐year local recurrence rates. Depth of invasion, cellular differentiation, vascular invasion, and the location and number of lymph node metastasis influence the 5‐year survival rate. Age, type of resection, obstruction or perforation of the primary tumor, and the surgeon's technique influence the 2‐year local recurrence rate. Accordingly, high ligation of major vascular pedicle, tumor‐free margins, resection of contiguous organs, and oophorectomy should improve survival and an additional benefit may be derived from complete excision of distal mesorectum and the “no–touch isolation technique”.

Early Local Recurrence of Rectal Cancer Showing Extremely Rapid Growth After Curative Surgery: Report of a Case

“…5 Consequently, the local recurrence of a rectal cancer above the peritoneal reflection, as seen in our patient, rarely occurs. The mechanisms of local recurrence are attributed to the growth of viable local cancer residues, the growth of residual positive lymph node tumors, the intraoperative spread of cancer cells, the intraluminal spread of cancer cells, intramural spread of cancer cells, or failure to detect another tumor.…”

“…Although long-term survival can only be achieved by surgery, the rate of curative surgery is very low, and the prognosis for patients with local recurrence is poor. 5,9 This case report serves to demonstrate that both treatment for the prevention of local recurrence and early detection are important. While early detection is clearly important, the prevention of local recurrence is also indispensable.…”

“…5,6,8 Other reports concerning the early detection of the local recurrence of rectal cancer after surgery include one by Tuscano et al 9 of a patient diagnosed 5 months after surgery, and one by Romano et al 10 of a patient diagnosed 7 months after surgery. 5,6,8 Other reports concerning the early detection of the local recurrence of rectal cancer after surgery include one by Tuscano et al 9 of a patient diagnosed 5 months after surgery, and one by Romano et al 10 of a patient diagnosed 7 months after surgery.…”

Laparoscopic surgery for colon cancer

“…Common sense dictates that the higher the vascular pedicle taken with the specimen, the less likely the recurrence [59]. Corder and collaborators, however, studied a series of 143 consecutive patients using a proportional hazards analysis and found no differences in recurrence or mortality, compared with the method of vascular ligation [60].…”

Mesorectal excision for rectal cancer: A view from Europe

“…We argue that studies on the effect of adjuvant treatment cannot and should not be evaluated unless the LR rate of surgery alone is less than 10%. As seen from Europe, it is a puzzling phenomenon to observe that some U.S. surgeons have consistently achieved excellent results after surgery (TME) alone [33,[84][85][86][87][88], but their results and opinions appear to have been ignored.…”