Surgical treatment of carcinoma of the abdominal colon

Eighty-eight consecutive patients with invasive, but potentially curable, carcinoma of the abdominal colon were operated upon between January 1970 through June 1974 at the University of Chicago Medical Center by a small group of senior surgeons, all of whom utilized extensive lymphadenectomy. Pathologic stage of the disease, lymph node involvement, contiguous organ involvement and degree of differentiation of the primary tumor affected survival rates. Five and ten year absolute survival rates were 71.2 and 50.0 per cent, and the relative survival rates were 78.1 and 60.9 per cent. By five years, 30.0 per cent of the patients had recurrence, and by ten years, 33.3 per cent had recurrence. The majority of recurrences occurred within three years of operation. Only 12 per cent of the recurrences were local or regional. We conclude that operation using wide anatomic resection and extended lymphadenectomy improves survival rates and limits local and regional recurrences in patients with carcinoma of the abdominal colon. Furthermore, surveillance of patients after operation for invasive carcinoma of the abdominal colon should be aggressive for at least the first three years because of the frequency of recurrence within this period.