Because of continued problems with local recurrence after surgery for
rectal cancer, extended resection of lymph node-bearing tissue has bee
n proposed, both to increase survival and to decrease local recurrence
. Such extended resection has often been associated with increased lon
g-term morbidity, particularly as regards urinary and sexual function.
A comparative analysis of currently available data with such extended
resections is presented, considering both survival and morbidity data
, and contrasting these data with results obtained with conventional r
esection. While it is not yet clear whether extended resections do in
fact increase survival, results are promising in several specific situ
ations, and work in progress has been successful in diminishing long-t
erm morbidity for many patients.