[Surgery for far-advanced colorectal cancer--extension of surgical indication and its results]

The role of extended surgery for far advanced colorectal cancer (stage V, IV) was discussed. As the progression of colorectal cancer is relatively slow and small, as compared to cancers of other digestive organs, removal of the far advanced carcinoma by much extended operation was effective to enhance the survival or quality of life of patients. Combined resection of adjacent organ involved has given many patients chance of cure. Total pelvic eviscerations were performed for thirty eight patients with far-advanced rectal cancer which involved adjacent organs. The results were a 51.5% 5-year survival rate for curative resected group. For advanced rectal cancer with a high degree of lymph-node metastasis, extension of lymph-node dissection up to the para-aortic region or ileo-pelvic lateral dissection en bloc with the internal iliac vessels were effective for decreasing the incidence of local recurrence. For seventy two patients with liver metastasis, radical surgery with removal of liver metastatic lesions post removed intra arterial infusion therapy (5FU,MMC) was carried out and the resulting 5-year survival rate was 40% for patients with H1 liver metastasis. Removal of pulmonary metastatic lesions was also performed in sixty five patients and the 5-year survival rate was 40%. A complete removal of scattered tumors (P1,P2) and administration of anticancer drug-MMC (20-30mg) in the peritoneal cavity was conjugated to prolong the terms of survival of patients.