Extended resection for primary colorectal carcinoma involving adjacent organs or structures

Involvement of adjacent organs by colorectal cancer has been associated historically with poor local control and survival. This can be improved by en bloc extended resection. A retrospective review was done of 58 patients who underwent this procedure. The operative mortality was 5%. Cases were divided into Gunderson-Sosin Stages B3 and C3. Five-year survival was markedly better for Stage B3 (64% versus 11%). Regardless of stage, local recurrence was increased, and 5-year survival decreased for those cancers with carcinomatous adhesions. At surgery, lesions cannot be staged accurately into C3 or B3 cancers. All such lesions should be resected. The B3 patients have a significant chance for cure, and C3 patients will have good local control despite their dismal 5-year survival.