Operative treatment of colorectal cancer

Principles of radical surgery for curative treatment of colon and rectal cancer are based on 5-year survival and 2-year local recurrence rates. Depth of invasion, cellular differentiation, vascular invasion, and the location and number of lymph node metastasis influence the 5-year survival rate. Age, type of resection, obstruction or perforation of the primary tumor, and the surgeon's technique influence the 2-year local recurrence rate. Accordingly, high ligation of major vascular pedicle, tumor-free margins, resection of contiguous organs, and oophorectomy should improve survival and an additional benefit may be derived from complete excision of distal mesorectum and the "no-touch isolation technique."