Survival Following Extended Operations for Extracolonic Invasion by Colon Cancer

McGlone, Thomas P.; Bernie, William A.; Elliott, Dan W.

doi:10.1001/archsurg.1982.01380290055010

Cited by 118 publications

(60 citation statements)

References 6 publications

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“…Thus, the present results provide support for the surgical strategy that radical resection should always be performed if technically feasible. The rate for serious surgical complications in this analysis ranged between 10 and 17 per cent, considerably lower than that reported in other series1, 3,15,16. Under reporting of complications as a result of the retrospective character of the present study does not explain this difference, as the complication rate was in the same range in another, prospectively collected, data set in one of the authors' hospitals: 6-14 per cent17.…”

Section: Discussioncontrasting

confidence: 66%

Radical resection of locally advanced colorectal cancer

Poeze

Houbiers

Velde

et al. 1995

Journal of British Surgery

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Multivisceral resection has been accepted as treatment for patients with locally advanced colorectal cancer. Nodal status has recently been claimed to be the most important predictor of survival in patients with such disease, with no survival after 2 years for patients with lymph node metastasis. A retrospective analysis was carried out of the prognostic significance of different tumour characteristics, and whether a more limited palliative resection is warranted in patients with positive lymph nodes. Of 1346 patients with colorectal adenocarcinoma operated on between 1987 and 1991, all those with a tumour staged as T4N0M0 or T4N1M0 (94 patients) were selected. From the remainder, 195 patients with stage T3N0M0 and T3N1M0 lesions were randomly selected as a control group. Overall survival was assessed at the beginning of 1993. The most important predictors of survival were lymph node status and involvement of the resection margins of the tumour. Overall survival in patients with T4 tumours who underwent radical resection was not significantly different from that in those with T3 tumours, even in N1 stages. Extended resection did not induce unacceptable morbidity or mortality. Surgery for locally advanced colorectal adenocarcinoma should result in tumour-free margins, and should therefore include multivisceral resection, even in patients with lymph node metastasis.

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Section: Discussioncontrasting

confidence: 66%

Radical resection of locally advanced colorectal cancer

Poeze

Houbiers

Velde

et al. 1995

Journal of British Surgery

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“…When this happens, the term "locally advanced colorectal cancer" is used, referring to tumors that infiltrate or adhere to adjacent organs without distant metastases. Locally advanced colorectal cancer is frequently considered to be an incurable disease, and it represents 5 to 22% of all colorectal carcinomas (1)(2)(3)(4)(5) . Extended or multivisceral resection is the treatment of choice.…”

Section: Introductionmentioning

confidence: 99%

En bloc pancreaticoduodenectomy and right hemicolectomy to treat locally advanced right colon cancer: report of three cases

Costa

Horta

Henriques

et al. 2010

Einstein (São Paulo)

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Although colorectal tumors are fairly common surgical conditions, 5 to 12% of these tumors are locally advanced (T4 tumors) upon diagnosis. In this particular situation, the efficacy of en bloc multivisceral resection has been proven. When right-colon cancer invades the proximal duodenum or even the pancreatic head, a challenging dilemma arises due to complexity of the curative surgical procedure. Therefore, en bloc pancreaticoduodenectomy with right hemicolectomy should be performed to obtain free margins. The present study reports three cases of locally advanced right-colon cancer invading the proximal duodenum. All of these cases underwent successful en bloc pancreaticoduodenectomy plus right hemicolectomy, with no death occurrence. Long-term survival was observed in two cases (30 and 50 months). In the third case, the patient did not present any recurrence twelve months after surgical treatment. Multivisceral resection with en bloc pancreaticoduodenectomy should be considered for patients who present acceptable risk for major surgery and no distant dissemination. This approach seems justified since the length of postoperative survival is longer in radically ressected groups (R0) than in palliativelly resected groups (R1-2).Keywords: Pancreaticoduodenectomy; Colorectal neoplasms; Colonic neoplasms; Adenocarcinoma; Case reports resUMo Embora os tumores colorretais sejam afecções cirúrgicas relativamente comuns, 5 a 12% dos casos são diagnosticados como localmente avançados (Tumores T4). Nessa situação particular, a eficácia da ressecção em monobloco já foi comprovada. Quando tumores do cólon direito invadem o duodeno proximal ou ainda a cabeça do pâncreas, um desafiador dilema é observado devido à complexidade do procedimento cirúrgico curativo. Dessa maneira, uma pancreaticoduodenectomia com hemicolectomia direita em monobloco deve ser realizada para se obterem margens livres. O presente artigo relata três casos de tumor de cólon direito localmente avançado com invasão do duodeno proximal. Todos esses casos foram submetidos à pancreaticoduodenectomia e hemicolectomia direita em monobloco de forma bem sucedida e sem mortalidade. Sobrevida em longo prazo foi observada em dois doentes (30 e 50 meses). No terceiro caso, o paciente não apresentava recidiva após 12 meses de seu tratamento cirúrgico. A ressecção multivisceral com pancreaticoduodenectomia em monobloco deve ser considerada em doentes com risco cirúrgico aceitável para cirurgia de grande porte e sem disseminação à distância. Essa conduta permanece justificada, pois a sobrevida a longo prazo dos doentes submetidos à ressecção radical (R0) é mais longa do que daqueles cuja ressecção é paliativa (R1-2).

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“…Patients who undergo resection with an adequate surgical margin have a prognosis similar to that of patients without involvement of adjacent organs on a stage-matched basis [5,6] . Local recurrence is frequently observed in patients who undergo dissection of adhesions [7,8] . Thus, right hemicolectomy combined with PD (en bloc resection) can achieve radical resection of the tumor, which can improve the survival Saiura et al [2] suggest that PD for advanced colon cancer invading the pancreas improves the long-term survival of the patient, unless the tumor is a node-positive or mucinous/poorly differentiated adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Right colon cancer presenting as hemorrhagic shock

Iwata¹,

Konishi

Yamazaki³

et al. 2011

WJGP

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A 67yearold man visited our hospital with a history of continuous hematochezia leading to hemorrhagic shock. An abdominal computed tomography scan re vealed a large mass in the ascending colon invading the duodenum and pancreatic head as well as extra vasation of blood from the gastroduodenal artery (GDA) into the colon. Colonoscopy revealed an irregular ulce rative lesion and stenosis in the ascending colon. There fore, right hemicolectomy combined with pyloruspreser ving pancreaticoduodenectomy was performed. Histolo gically, the tumor was classified as a moderately differentiated adenocarcinoma. Moreover, cancer cells were main ly located in the colon but had also invaded the duode num and pancreas and involved the GDA. Immunohisto chemically, the tumor cells were positive for cytokeratin (CK)20 and carcinoembryonic antigen (CEA) but not for CK7 and carbohydrate antigen (CA)199. The patient died 23 d after the surgery because he had another episode of arterial bleeding from the anastomosis site. Al though En bloc resection of the tumor with pancreatico duodenectomy and colectomy performed for locally ad vanced colon cancer can ensure longterm survival, patients undergoing these procedures should be carefully monitored, particularly when the tumor involves the main artery.

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Survival Following Extended Operations for Extracolonic Invasion by Colon Cancer

Cited by 118 publications

References 6 publications

Radical resection of locally advanced colorectal cancer

Radical resection of locally advanced colorectal cancer

En bloc pancreaticoduodenectomy and right hemicolectomy to treat locally advanced right colon cancer: report of three cases

Right colon cancer presenting as hemorrhagic shock

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