Survival after extended resection for locally advanced carcinomas of the colon and rectum.

Two hundred and fifty five patients were treated surgically for adenocarcinoma of the colon or rectum on the Surgical Unit at Westminster Hospital in the years 1962-78. After 13 patients had been excluded on the grounds of inadequate data, 57 of the remaining 242 had tumours which, at laparotomy, were firmly adherent to neighbouring organs or the abdominal wall. These 'locally advanced' tumours were treated by an extended en-bloc resection of the tumour and neighbouring organs. The operative mortality after extended resections was higher than after standard resections, but subsequent survival did not differ significantly from survival after standard excisions for tumours of the same Dukes' stage. Histological examination of the neighbouring organs included in the extended resections confirmed direct tumour spread in only 33%.