Annals of Coloproctology

Original Articles

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer

Feasibility and Outcomes of Multivisceral Resection in Locally Advanced Colorectal Cancer: Experience of a Tertiary Cancer Center in North-East India: Joydeep Purkayastha, Pritesh Rajeev Singh, Abhijit Talukdar, Gaurav Das, Jitin Yadav, Srinivas Bannoth; Ann Coloproctol. 2021;37(3):174-178. Published online July 3, 2020; DOI: https://doi.org/10.3393/ac.2020.06.03

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Purpose
Locally advanced colorectal cancer may require an en bloc resection of surrounding organs or structures to achieve complete tumor removal. This decision must weigh the risk of complications of multivisceral resection against the potential survival benefit. The purpose of this study is to review a single-center experience of feasibility of en bloc multivisceral resections for locally advanced colorectal carcinoma and to examine the effect of surgical experience on immediate outcome and rate of R0 resections.
Methods
This is a study of 27 patients who underwent multivisceral resection for locally advanced colorectal carcinoma which was performed at our institute from January 2016 to December 2019. Among the 27 patients aged between 21 and 76 years (mean age, 48.67±7.3 years), 13 were males and 14 were females. Overall 18 patients had primary colon carcinoma and 9 had primary rectal carcinoma. All rectal cancer patients received neoadjuvant chemoradiation. All patients underwent surgery with curative intent. All patients underwent open surgery of which 66.7% underwent colectomy, 14.8% underwent anterior resection, 11.1% underwent Miles procedure, and 7.4% underwent pelvic exenteration.
Results
The mean operative time was 268.14±72.2 minutes and the median amount of blood units transfused was 2.07 units. The mean hospital stay was 13.67±3.4 days. Histologically, 44.4% of patients had well-differentiated adenocarcinoma and 55.6% had moderately differentiated adenocarcinoma. The final histopathological examinatio n revealed malignant infiltration of the adjacent organs in 19/27 patients (70.4%). Pathological complete response was seen in 2 patients. R0 resection rate achieved was 96.3%. Lymph node metastasis was seen in 66.7% of patients with colon cancer and 11.1% with rectal cancer with overall mean number of harvested lymph nodes being 12.44±3.01. Postoperative complications were identified in 7 patients (25.9%), while mortality was seen in 2 (7.4%).
Conclusion
Multivisceral resection for advanced colorectal cancer invading into the adjacent organ may be performed with acceptable morbidity and mortality.

Citations

Citations to this article as recorded by

Comparison of short- and long-term outcomes between laparoscopic and open multivisceral resection for clinical T4b colorectal cancer: A multicentre retrospective cohort study in China
Jinzhu Zhang, Jinfeng Sun, Junguang Liu, Shiwen Mei, Jichuan Quan, Gang Hu, Bo Li, Meng Zhuang, Xishan Wang, Jianqiang Tang
European Journal of Surgical Oncology.2024; 50(1): 107316. CrossRef
Analysis of Patient Outcomes following Curative R0 Multiorgan Resections for Locally Advanced Gastric Cancer: A Systematic Review and Meta-Analysis
Viorel Dejeu, Paula Dejeu, Anita Muresan, Paula Bradea, Danut Dejeu
Journal of Clinical Medicine.2024; 13(10): 3010. CrossRef
Prognostic stratification of patients with pT4bN0M0 colorectal cancer following multivisceral resection: a multi-institutional case series analysis
Jichuan Quan, Kai Zuo, Guoli Li, Junguang Liu, Shiwen Mei, Gang Hu, Wenlong Qiu, Meng Zhuang, Ling Meng, Xishan Wang, Hu Chang, Jianqiang Tang
International Journal of Surgery.2024; 110(9): 5323. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
The Ewha Medical Journal.2022;[Epub] CrossRef

Surgery for Lung Metastases from Colorectal Cancer.: Paik, Hyo Chae , Maeng, Dae Hyeon , Song, Suk Suk , Kim, Kil Dong , Chung, Kyung Young; J Korean Soc Coloproctol. 2002;18(1):37-41.

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Abstract PDF: PURPOSE
The liver and lung are the most common site of metastases after curative resection of colorectal carcinoma, and only 10 months of median survival is achieved once metastases has occurred in the lung. About 10% of patients have a solitary pulmonary metastasis and surgical resection leads to a 5 year survival rate of 21~43%. We have tried to define ideal candidates for pulmonary resection in a patient with pulmonary metastases from colorectal carcinoma.
METHODS
Between March 1990 to Feb. 2001, 25 patients underwent pulmonary resection for metastatic colorectal carcinoma. 15 patients were male, and 10 were female with mean age of 60.0 (range, 36~73) years. The primary sites were colon in 7 patients and rectum in 18 patients.
RESULTS
The mean disease free interval was 30.04 19.79 (range, 1~84) months and 19 patients had single metastasis and 6 patients had multiple metastatic lesions. Twenty- one patients had unilateral lesion. Wedge resection was done in 10 patients, lobectomy in 7, pneumonectomy in 2, wedge resection with bilobectomy in 2, segmentectomy and wedge resection in 1, and segmentectomy and lobectomy in 1 patient. Six patients recurred mean 13.7 months after the first operation (range, 1~33 months) and they underwent wedge resection in 4 and one case each of lobectomy and segmentectomy. Seven patients died during follow up with 3 year survival rate of 70.8% and 5 year survival rate of 43.4%.
CONCLUSIONS
The disease free interval, number of metastases, type and location of pulmonary resection, level of carcinoembryonic antigen had no correlation with the survival rate. We conclude that surgical resection of colorectal lung metastases is safe and effective, and every patients should be evaluated as a surgical candidate.

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