[Extended resection in locally advanced colon cancer]

Colorectal malignant tumors with a mono o multivisceral involvement have a poor prognosis and surgery is the only treatment with a hope to be curative. Aggressive surgical management of locally advanced colo-rectal cancer seems to be justified by good oncological results. At the Institute of Clinica Chirurgica of the University of Trieste 58 extended resections were performed for advanced tumors of colon and rectum. The specific morbidity rate was 24% for standard and 24.1% for extended resections. Operative morality was 15.2%; hystological specimen confirmed in 31 cases neoplastic infiltration of contigous structures. The 5 year survival rate was 38.5% in right colonic tumors and 53.3% in left colonic tumors. The literature favors an aggressive approach when the tumor adhesions are suspected. The excision of adjacent organs, whether or not they are microscopically involved by the tumor, is necessary to avoid leaving potentially curable disease The authors, analyzing their results, have also reported good results by management including resection of the colon and contigous organs if involved. Palliative therapy must be performed only if liver metastases are detected or in those cases when primary resection is not thecnically feable or in patients not able to tolerate the procedure.