Multivisceral resection for colon cancer.

BACKGROUND

There is a lack of appropriate information in regard to the optimal treatment for colon cancer infiltrating neighboring organs.

OBJECTIVES

The objective of this study is to analyze treatment results and to identify the risk factors of death by cancer in these patients.

METHODS

A retrospective analysis of 40 patients with colon cancer infiltrating neighboring organs without distant metastases was carried out. Patterns of recurrence and 5-year survival were analyzed.

RESULTS

The study included 20 males and 20 females with a median age of 51.5 years. Primary tumor location was as follows: right colon (n = 15); transverse colon (n = 5); left colon (n = 7), and sigmoid (n = 13). In 17 patients, the colon tumor infiltrated the abdominal wall alone or together with neighboring organs and in 23 patients, one or more neighboring organs were infiltrated. Eleven patients (27.5%) developed postoperative complications. Two patients (5%) died during the postoperative period. Microscopic tumor infiltration was demonstrated in 29 patients (72.5%). Tumor stage was as follows: T3,N0 (n = 8); T3,N+ (n = 3); T4,N0 (n = 16), and T4,N+ (n = 13). Overall 5-year survival was 45%. Multivariate analysis shows that the unfavorable risk factors for 5-year survival were neoplastic cell infiltration to neighboring organs, age > 50 years, and lymph node metastases.

CONCLUSIONS

The main risk factors for cancer-related failure are neoplastic infiltration to neighboring organs, age > 50 years, and lymph node metastases. In T4 colon cancer, the recurrence pattern was found at local, peritoneal, and distant sites.