Clinicopathological Studies and Treatment for Colorectal Carcinoma with Invasion to Adjacent Organs

Tamotsu Tsutsui, Kazuaki Sasaki, Masashi Oku, Hiroshi Hayasaka

First Department of Surgery, Sapporo Medical College

A total pf 635 patients with primary colorectal carcinoma were treated surgically at our clinic from 1977 through 1988. Invasion to adjacent organs was noted in 51 of the patients (8.0%). Tumor invasion was recognized in the stomach, duodenum, small intestine, urinary bladder, ureter and female genital organs. Most of the tumors had entirely circumferential growth and were diagnosed as type 3 in macroscopic classification. Pathohistological findings of these tumors revealed moderately differentiated adenocarcinoma. The rate of curative resection was 50% for colonic carcinoma and 55.2% for rectal carcinoma, but the rate was low in the transverse colon and lower rectum compared with other regions. The 5-year survival rate for curative resection was 73% for the patients with colonic carcinoma and 19% for those with ractal carcinoma. In the patients undergoing curative resection, patient's life was obviously prolonged in comparison with those undergoing noncurative resection or with nonresectable carcinoma. Because distant lymph node metastasis and hematogenous matastasis were comparatively few in spite of tumor invasion to adjacent organs. Therefore, speedy procedure for exact diagnosis of malignancy and active planning for combined resection including pelvic exenteration are needed in order to obtain better results in the patients without distant metastasis.

Key words
colorectal carcinoma, combined resection, curative resection, noncurative resection, invasion to adjacent organs

Reprint requests
Tamotsu Tsutsui First Department of Surgery, Sapporo Medical College
S-1, W-16, Chuo-ku, Sapporo, 060 JAPAN

Accepted
March 13, 1991

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