Results after multivisceral resections of locally advanced colorectal cancers: an analysis on clinical and pathological t4 tumors
| Autor: | Metin Kement, Mesut Seker, Selahattin Vural, Nuri Okkabaz, Mahmut Gumus, Mustafa Oncel, Cem Gezen, Yunus Emre Altuntas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer lcsh:Surgery pT4 tumor Adenocarcinoma Lower risk locally advanced colorectal cancer lcsh:RC254-282 survival Postoperative Complications Surgical oncology Humans Medicine Prospective Studies Prospective cohort study Survival rate Pathological Neoplasm Staging multivisceral resection business.industry Research General surgery morbidity and mortality lcsh:RD1-811 Perioperative Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Prognosis medicine.disease Surgery Survival Rate Viscera Oncology Lymphatic Metastasis Female Neoplasm Recurrence Local Colorectal Neoplasms business Follow-Up Studies |
| Zdroj: | World Journal of Surgical Oncology World Journal of Surgical Oncology, Vol 10, Iss 1, p 39 (2012) |
| Popis: | Background Locally advanced colorectal cancers are best treated with multivisceral resections. The aim of this study is to evaluate early and late results after multivisceral resections. Methods All patients operated for primary colorectal cancer between 2001 and 2010 were -reviewed. These were compared within the patients underwent single organ and multivisceral resections: demographics, tumor and procedure related parameters, perioperative results, early oncological outcomes and 5-year survival. Results A total of 354 patients (59.6 ± 13.8 years old, 210 [59.3%] males) were abstracted. Ninety (25.4%) patients underwent multivisceral resections for clinical T4 tumors and en-bloc R0 resection was achieved in 82 (91.1%). Only 31 (34.4% and 8.8% of clinical T4 and all cancers, respectively) cases had actual adjacent organ invasions (pT4). Males (20%) had lower risk for locally advanced tumors than females (33.3%) (p < 0.05). PT4 cancers were more common, if the clinical T4 tumor is located in the colon (48.8% vs 21.3%; p < 0.01). Laparoscopy was seldom initiated and the risk of conversion was higher in clinical T4 tumors (p < 0.05). The rates of sphincter-saving procedures were not different. Operation time, bleeding and transfusion requirements increased when multivisceral resections were necessitated (p < 0.05), but hospital stay, complications and 30-day mortality rates were similar. The 5-year survival rates were identical (p > 0.05). Conclusions Clinical T4 tumors are not rare and more common in women. An actual invasion (pT4) may be observed in one third of all clinical T4 tumors, and more frequent in colon cancers. An en-bloc, R0, multivisceral resection may be achieved in most cases. Multivisceral resections do not alter the rates of sphincter-saving procedures, morbidity and 30-day mortality; do not worsen survival but increase operation time, intraoperative bleeding and perioperative transfusion requirements. |
| Databáze: | OpenAIRE |
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