Multivisceral resection for colon cancer: analysis of prognostic factors

To assess outcome of multivisceral resection in colon cancer patients and to identify predictors of survival.

One hundred and thirteen consecutive patients with primary locally advanced colon cancer infiltrating adjacent organs undergoing multivisceral resection between 1998 and 2007 were reviewed. Overall survival and disease-free survival were analyzed by the Kaplan-Meier method. The relative risk for clinical outcome was obtained using a Cox multivariate model.

The median follow-up was 74.9 months. Fifty-two patients had sigmoid tumors and 48 involvement of the small intestine. Complications occurred in 54 patients. The diagnosis was conventional adenocarcinoma in 94 patients. R0 resection was achieved in 96 patients (85%). Eighty-three patients received postoperative adjuvant therapy. The operative mortality was 7.1% (8 patients). Sixty-seven patients died at follow-up. Of the 46 patients who were alive, 38 were free of disease. In 73 patients with pT4a disease, 42 patients died (57.5%) and of the 31 survivors, recurrence was documented in 6. Hematochezia and adjuvant chemotherapy were independent factors of favorable outcome and grade G3 and tumor stage III-IV of poor survival.

Hematochezia and adjuvant chemotherapy were associated with a better survival, and poorly differentiated tumors and stage IV disease with a poor survival.