EXTENDED RADICAL RESECTION FOR LOCALLY AD VANCED COLORECTAL-CARCINOMA

The results of extended resections for locally advanced colorectal can cer and the factors influencing the long term survival and recurrence rate are analized in 69 patients. All of them underwent radical enbloc resection including the primary tumor and the adyacent affected struc tures. The existence of tumoral invasion was confirmed in 42 cases (60 %). In the remaining, inflammatory adhesions were presents. Overall 5 year survival did not show significant differences between the groups of patients with benign or malignant infiltration (71% y 51% respectiv ely). Within the same tumor stage, the results were similar for the tw o types of infiltration. Significant differences were found when lymph nodes metastases were considered: 65% 5 year survival in patients wit h negative lymph nodes versus 35% in patients with positive nodes. The probability of metastases and tumor recurrence was significantly high er in the group with malignant infiltration. Patients with positive ly mph nodes showed lower disease-free interval rate. These data show tha t long term control of the tumor in locally advanced colorectal carcin omas can be achieved by an aggresive surgical approach. The presence o f lymph mode metastases is a more useful prognostic factor influencing survival and relapse rate that the local infiltration by it-self.