Prognosis after surgery in patients with incurable rectal cancer: a population-based study.

In a defined population between 1973 and 1992 151 patients with irresectable metastatic or local rectal cancer were identified. Eighty-one patients underwent resection of the primary tumour (group 1) whereas the primary tumour was left in situ in 70 patients (group 2). During the same time period, 444 patients underwent curative resection. The median survival was 7.5 months in group 1, and 3.5 and 1.9 months for surgically and non-surgically treated patients respectively in group 2. A colostomy for intestinal obstruction became necessary in 12 per cent of the patients with a retained primary tumour. Bilateral hepatic involvement, abnormal liver function test results, peritoneal growth or abdominal lymph node metastases correlated with a short survival (P < 0.01). These results support a selective approach to patients with incurable rectal cancer.