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. 2018 Mar;8(3):493-498.
doi: 10.3892/mco.2018.1559. Epub 2018 Jan 19.

Multivisceral resections for locally advanced colorectal cancer after preoperative treatment

Takeshi Nishikawa  1 , Soichiro Ishihara  1 , Shigenobu Emoto  1 , Manabu Kaneko  1 , Koji Murono  1 , Kazuhito Sasaki  1 , Kensuke Otani  1 , Toshiaki Tanaka  1 , Tomomichi Kiyomatsu  1 , Keisuke Hata  1 , Kazushige Kawai  1 , Hiroaki Nozawa  1 , Toshiaki Watanabe  1
Affiliations

Multivisceral resections for locally advanced colorectal cancer after preoperative treatment

Takeshi Nishikawa et al. Mol Clin Oncol. 2018 Mar.

Abstract

Multivisceral resection for colorectal cancer invading into the adjacent organs may often be difficult and may involve serious complications. Preoperative therapy may facilitate resection with safe margins. Between August 2007 and July 2016, 23 patients with colorectal cancer invading into the adjacent organs treated with preoperative treatment (chemoradiotherpay, chemotherapy, radiotherapy) were retrospectively investigated. All 23 patients received surgery with curative intent. Four patients had distant metastases at the time of diagnosis. Two patients had distant metastasis after preoperative treatment. The mean operative time was 535.3±185.5 min and the median amount of blood loss was 1,050 ml. Histopathological examination revealed malignant infiltration of the adjacent organs in 14 patients (60.9%). R0 resection rate was 73.9%. Postoperative complications were identified in nine patients (39.1%) and a high incidence of infectious complications was observed. Patients with curative resection showed a significantly better survival than patients with R1 or R2 resection (P<0.01). Multivisceral resection for locally advanced colorectal cancer invading into the adjacent organ after preoperative treatment may be performed with acceptable morbidity and minimal mortality. R0 resection improves the prognosis of patients with locally advanced colorectal cancer invading into the adjacent organ after preoperative treatment.

Keywords: chemoradiotherapy; chemotherapy; colorectal cancer; invasion; radiotherapy.

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Figures

Figure 1.
Figure 1.
(A) Disease free survival according to R classification. Six of 13 patients with curative surgery had recurrence. Patients with curative surgery showed a significantly better disease-free survival than those with R1 resection (P<0.05). (B) Overall survival according to R classification. Patients with curative surgery showed a significantly better overall survival than the patients with R1 resection or those with R2 resection (P<0.01).
See this image and copyright information in PMC

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