Standardized treatment of colorectal cancer. A prospective study

304 patients with colorectal adenocarcinoma underwent standardized, aggressive treatment which included wide resection, adjuvant radio- or chemotherapy and management of advanced disease. The mean age of the patients was 68 years; 50% were older than 70 years, and 17% above 80 years. The resectability rate was 86.2%. Overall postoperative mortality was 7.3%, in patients operated on for cure 5.7%, and in patients more than 80 years 16.3%. The highest postoperative mortality was seen following right hemicolectomy and deaths were mainly caused by anastomotic leakage and myocardial infarction. In patients with primarily inoperable rectal cancer treated with irradiation and followed by attempted curative surgery, the estimated 5-year survival was 38%. In patients with operable rectal cancer treated with preoperative irradiation followed by surgery the 5 year survival was 69% as compared to 45% for those treated with surgery only. Adjuvant cytostatic therapy in patients with colonic tumours of Dukes B and C stages did not improve survival.