Comparison of obstructing and nonobstructing carcinoma of the colon

T is one that is intimately related to carcinoma of the colon. A recent study noted that carcinoma of the colon is the most common cause of colonic obstruction.9 There has been a realization in the last 15 years that the 5-year outlook for patients with obstructing carcinoma of the colon is a less optimistic one than that for patients with nonobstructing lesions. One of the earliest demonstrations of this was that of Nickel1 and Dockerty in 1948.6 They noted a 5-year survival of 25.7% in 37 patients treated with resection after a colostomy had been performed a short time previously for an obstructing carcinoma of the left colon. This was compared with a 5-year survival of 51.7% in 329 patients treated with resection who had nonobstructing lesions. All of these lesions were present in the descending colon and sigmoid colon. In 1961, Wilder and associatesll made a study comparing the 5-year survival rate in patients with obstructing and nonobstructing carcinomas of the right colon. They found 20 cases of obstructing carcinoma of the right colon from 1910 to 1943. Also studied were 53 cases of partially obstructing and 73 cases of nonobstructing carcinoma of the right colon. These cases of obstructing lesions were divided according to their location in the right colon, and a 5-year survival of 22% was found for patients with hepatic flexure lesions. The patients with obstructing lesions of the ascending colon had a 5-year survival of 33'3, . Both of the 2 patients with obstructing lesions of the cecum died within 5 years. There was a 5-year survival of approximately 66% for the patients with nonobstructing lesions of the right colon.