Adenocarcinoma of the sigmoid colon: sites of initial dissemination and clinical patterns of recurrence following surgery alone.

Three hundred and fifty-five patients with primary adenocarcinoma of the sigmoid colon were retrospectively reviewed. One hundred and eighteen patients who had disseminated disease at diagnosis were analyzed to identify sites and mechanisms of disease spread. Two hundred and thirty-seven patients treated by surgery alone with curative intent were analyzed to determine clinical patterns of recurrence and identify prognostic factors. Operative findings in 27 patients undergoing second laparotomy at the time of initial disease recurrence are described, and implications for adjuvant therapy discussed.