[Colonic cancers. Results of surgical treatment and prognosis. 579 cases]

Between 1964 and 1981, 579 patients were operated upon for carcinoma of the colon. Hepatic and/or peritoneal metastases were present in 17.3%. Excision was performed in 530 cases (91.5%). Carcinomas of the left colon were usually treated by segmental resection. The peritoneum and lymph nodes were involved in 21.7% and 31% respectively of the patients who underwent resection. There were 6 post-operative deaths: 2 after exploratory or derivative surgery and 4 after excision of the tumour. All but 8 of the 395 patients operated upon before 1978 were followed up; 229 survived for more than 5 years, 58% of all operated patients and 63.6% of those who had their tumour excised. The 5-year survival rate was 6% after palliative excision and 73.6% after curative excision (caecum and ascending colon: 81%; transverse colon: 83%; descending colon: 65%; sigmoid flexure: 70.7%). Tumoral invasion in depth and lymph node involvement had a significant influence on prognosis. Based on Dukes' classification, the 5-year survival rates for stages A, B, C and D tumours were 89%, 75.4%, 54% and 6% respectively. The time elapsed between the first symptoms and the operation did not alter the prognosis which was slightly better in women and in young patients.