LOCALLY ADVANCED-CARCINOMA OF THE COLON AND RECTUM INVOLVING THE URINARY-BLADDER

We reviewed the records of 70 patients who underwent resection of a ca rcinoma of the colon and rectum with en bloc total cystectomy (36 pati ents) or partial cystectomy (34 patients) because of tumor directly ex tending into the urinary bladder. Preoperative genitourinary symptoms were present in 33 of the 70 patients (41.7 percent) and were highly p redictive of malignant invasion of the bladder (97.0 percent). Duratio n of catheter drainage after partial cystectomy correlated with early postoperative bladder function; all 25 patients who had the catheter r emain in place at least ten days had normal voiding after catheter rem oval, while five of nine patients whose catheter was removed before te n days had retention requiring catheter reinsertion (p<0.01). Urologic complications occurred in two patients after total cystectomy and in three patients after partial cystectomy. There were three postoperativ e deaths in die total cystectomy group but none after partial cystecto my. Sixty-four patients with negative resection margins had a median s urvival period of 34 months and a five-year actuarial survival rate of 51.8 percent. In contrast, the median survival period for six patient s who had positive margins was 11 months, with no survivors at five ye ars.