Clinicopathological Studies of the Colorectal Cancer with Extracolonic Invasions

Masanori Tada, Tetsujin Kure, Masaaki Kanemobu, Masahiro Tsubaki, Eiichi Yabata, Satoshi Okabe, Mitsuo Endo

The First Department of Surgery, Tokyo Medical and Dental University School of Medicine

Of 511 cases of resected colorectal cancer, extracolonic invasions were proved macroscopically in 68 cases (13.3%), though microscpic invasion were found in only 39 cases (7.6%). These 39 cases included 22 female cases and 27 cases with lymphatic spread. Extracolonic invasion frequently involved small intestine, urinary bladder and female genital organs, reflecting the anatomical relationship between the primary cancer and invaded organs. Combined resection of the invaded organs was performed in 26 cases (66.7%) and was curative in 23 cases (59.0%). In five-year survival rate, a statistically significant difference was found between curative cases (5 yr. s.r.=57.1%) VS noncurative cases (5 yr, s.r=0%). Compared with the cases of serosal invasion (170 cases), the cases with extracolonic invasions have following features; they frequently found in female and right colon; in curative cases, five-year survival rate of n(+) cases was significantly lower than that of n(-) cases (34.1% VS 75.0%). In conclusion, combined resection is expected to bring better prognosis and should be performed as possible to attain curative operation, especially in cases without lymphatic spread. After surgery, patients with lymphatic spread should be carefully observed because of the high frequency of recurrence, even if a curative operation was performed.

Key words
colorectal cancer, extracolonic invasion, combined resection of invaded organs, 5years survival rate, lymphnode metastasis

Reprint requests
Masanori Tada The First Department of Surgery, Tokyo Medical and Dental University School of Medicine
1-5-45 Yushima, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
April 13, 1994

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