OBJECTIVES: To evaluate the incidence surgical results and prognostic factors of locally advanced colorectal cancer. METHODS: Cohort study including 679 colorectal cancer patients treated from 1997 to 2007. Clinical, surgical and histological data were analyzed. RESULTS: Ninety patients (females 61%; median age 59 years) were treated for locally advanced carcinomas (13.2%), either in the colon (66%) or rectum (34%). Extended resections most commonly involved the small bowel (19.8%), bladder (16.4%), uterus (12.9%) and ovaries (11.2%). Postoperative morbidity and mortality occurred in 23 (25.6%) and 3 (3.3%) patients, respectively. Survival and recurrence analysis among 76 R0 (84.4%) procedures revealed a 60% 5-year survival and 34% local recurrence rates. Survival curves demonstrated reduced rates for rectal location (45% vs 65%), tumor depth (50% for T4 vs 75% for T3), vascular/ lymphatic/perineural invasion (35% vs 80%) and lymph node metastasis (35% vs 80%). CONCLUSIONS: Locally advanced carcinomas were found in 13.2% of patients. Survival rates were negatively affected by rectal location and adverse histological features. Number of involved organs and neoplastic adhesions did not influenced chances of survival. A radical R0 extended resection was achieved in a high proportion of cases, resulting in a 60% cancer-free survival under acceptable operative risks.
OBJECTIVES: To evaluate the incidence surgical results and prognostic factors of locally advanced colorectal cancer. METHODS: Cohort study including 679 colorectal cancerpatients treated from 1997 to 2007. Clinical, surgical and histological data were analyzed. RESULTS: Ninety patients (females 61%; median age 59 years) were treated for locally advanced carcinomas (13.2%), either in the colon (66%) or rectum (34%). Extended resections most commonly involved the small bowel (19.8%), bladder (16.4%), uterus (12.9%) and ovaries (11.2%). Postoperative morbidity and mortality occurred in 23 (25.6%) and 3 (3.3%) patients, respectively. Survival and recurrence analysis among 76 R0 (84.4%) procedures revealed a 60% 5-year survival and 34% local recurrence rates. Survival curves demonstrated reduced rates for rectal location (45% vs 65%), tumor depth (50% for T4 vs 75% for T3), vascular/ lymphatic/perineural invasion (35% vs 80%) and lymph node metastasis (35% vs 80%). CONCLUSIONS: Locally advanced carcinomas were found in 13.2% of patients. Survival rates were negatively affected by rectal location and adverse histological features. Number of involved organs and neoplastic adhesions did not influenced chances of survival. A radical R0 extended resection was achieved in a high proportion of cases, resulting in a 60% cancer-free survival under acceptable operative risks.
Authors: Julia Parrish-Novak; Kelly Byrnes-Blake; Narine Lalayeva; Stefanie Burleson; Janean Fidel; Rhonda Gilmore; Pamela Gayheart-Walsten; Gregory A Bricker; William J Crumb; K S Tarlo; Stacey Hansen; Valorie Wiss; Errol Malta; William S Dernell; James M Olson; Dennis M Miller Journal: Int J Toxicol Date: 2017-03-17 Impact factor: 2.032
Authors: Cristina A Metildi; Sharmeela Kaushal; Cynthia S Snyder; Robert M Hoffman; Michael Bouvet Journal: J Surg Res Date: 2012-09-07 Impact factor: 2.192
Authors: Cristina A Metildi; Sharmeela Kaushal; George A Luiken; Mark A Talamini; Robert M Hoffman; Michael Bouvet Journal: J Surg Oncol Date: 2013-11-19 Impact factor: 3.454