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Diseases of the Colon & Rectum
Published in: Diseases of the Colon & Rectum 12/2004

01-12-2004 | Original Contributions

Comparison of Multivisceral Resection and Standard Operation for Locally Advanced Colorectal Cancer: Analysis of Prognostic Factors for Short-Term and Long-Term Outcome

Authors: Yuji Nakafusa, M.D., Toshiya Tanaka, M.D., Masayuki Tanaka, M.D., Yoshihiko Kitajima, M.D., Seiji Sato, M.D., Kohji Miyazaki, M.D.

Published in: Diseases of the Colon & Rectum | Issue 12/2004

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PURPOSE

The aim of the present study is to clarify the characteristics of multivisceral resection and to discuss strategies for improving the overall outcome of multivisceral resection for locally advanced colorectal cancer.

METHODS

The study included 323 patients who electively underwent curative surgery for pT3–pT4 colorectal carcinoma without distant metastasis. We evaluated the short-term and long-term outcome of multivisceral resection relative to that of the standard operation by means of multivariate analysis of the prognostic factors.

RESULTS

Of 323 patients, 53 (16.4 percent) received multivisceral resection because of adhesion to other organs. Multivisceral resection was significantly associated with tumor size, depth of invasion, operative blood loss, operation time, and blood transfusion (all: P < 0.0001). Overall morbidity rates were 49.1 percent after multivisceral resection vs. 17.8 percent after the standard operation (P < 0.0001), and postoperative mortality rate was 0 percent in both groups (not significant). Only multivisceral resection (odds ratio, 2.725; 95 percent confidence interval, 1.125–6.623; P = 0.0264) was an independent factor for overall postoperative complications. The survival rate of patients after multivisceral resection was similar to that after the standard operation (5-year rate, 76.6 percent vs. 79.5 percent, P = 0.9347). Lymph node metastasis (hazard ratio, 2.510; 95 percent confidence interval, 1.460–4.315; P = 0.0009) and blood transfusion (hazard ratio, 2.353; 95 percent confidence interval, 1.185–4.651; P = 0.0145) were independently associated with patient survival.

CONCLUSIONS

For locally advanced colorectal cancer, the long-term outcome after multivisceral resection is comparable to that after the standard operation. However, it should be recognized that multivisceral resection is associated with higher postoperative morbidity. In addition, a reduction in the incidence of blood transfusion may contribute to improving patient survival.
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Metadata
Title
Comparison of Multivisceral Resection and Standard Operation for Locally Advanced Colorectal Cancer: Analysis of Prognostic Factors for Short-Term and Long-Term Outcome
Authors
Yuji Nakafusa, M.D.
Toshiya Tanaka, M.D.
Masayuki Tanaka, M.D.
Yoshihiko Kitajima, M.D.
Seiji Sato, M.D.
Kohji Miyazaki, M.D.
Publication date
01-12-2004
Publisher
Springer-Verlag
Published in
Diseases of the Colon & Rectum / Issue 12/2004
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-004-0716-7

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