Contrivance of Pre-, Intra-and Postoperative Treatment for Recurrent Cases of Colorectal Cancer

Kazuaki Okuyama, Yoshio Koiede, Hiromasa Matsubara, Hisahiro Matsubara, Hitoshi Kinoshita, Yutaka Funami, Kazuyuki Mastushita, Tetsuroh Urashima, Masataka Katoh, Susumu Kobatashi, Nobuyuki Nakajima*, Kaichi Isono

Second Department of Surgery, School of Medicine, Chiba University
*First Department of Surgery, School of Medicine, Chiba University

Pre- intra- and postoperative treatments for colorectal cancer and the results were studied through recurrent cases. The subjects included 770 resected cases and 94 cases with hepatectomy in our instisute and 500 cases registered in a joint research colorectal cancer 37 institutions. In 160 recurrent cases (excluding absolute noncurative operated cases), the largest number of recurrences was organ metastasis in 85 cases (53.1%), with liver metastasis accounting for 68.2%, followed by local recurrence in 49 cases (30.6%) and anastomosis in 36.8%. Preoperative intraarterial infusion therapy like TAI or TAE before hepatectomy and postoperative intraarterial infusion therapy of MMC and ADM were effective for metachronous liver metastasis. Intraoperative rectal irrigation with nore than 2000 ml of saline in the cases of anterior resection was useful for prevention of implantation metastasis. The rate of hematogenic metastasis was significantly lowered in patients with curative operation treated with postoperative chemotherapy of 5FU or MMC and adjuvant chemotherapy of HCFU.

Key words
colorectal cancer, recurrence of implantation

Reprint requests
Kazuaki Okuyama Second Department of Surgery, School of Medicine, Chiba University
1-8-1 Inohana, Chuohku, Chiba-city, 260 JAPAN

Accepted
July 6, 1994

To read the PDF file you will need Abobe Reader installed on your computer.