[Cancers of the sigmoid and upper rectum extending to the bladder or ureter, treated by monobloc resection. Apropos of 13 cases].

The aim of this retrospective study is to assess the operative and functional risks and the results of "en bloc resection" performed for tumors of the sigmoid colon or of the rectum extending to the bladder. Thirteen patients required this resection, the sigmoid was involved in ten cases, the rectum in three. The urinary tract involvement was an operative finding in ten cases, while recurrent cystitis was observed in three cases. This extension reached the dome of the bladder in 11 cases, and the terminal portion of the ureter in 2 cases. All the patients underwent curative "en bloc resection" including colectomy and partial cystectomy or cysto-ureterectomy: operative mortality was 7.6%. Precise histological staging of lymph node and bladder involvement was only obtained in 11 cases; all were Astler Coller's stage B2. In 9 cases the malignant tissue involved the urinary tract; in 2 cases there were only inflammatory adhesions. In all cases the functional urinary results were good. The 5 year direct survival rate was 50%; following Kaplan Meier's actuarial method this rate was 68%. Bladder involvement by a colonic or rectal adenocarcinoma does not seem to have any "en bloc resection" is worthwhile for this kind of extensive prognostic valve.