Survival following extended operations for extracolonic invasion by colon cancer

Of 460 cases of colon cancer treated between 1972 and 1976, 24 were unusual. These patients required en bloc resection of the colon with one or more adjacent organs for dense adhesions between the colon and these organs. In 66% of the cases these adhesions represented microscopic tumor invasion. Lymph nodes were positive for disease, stage C-3, in only four specimens. The pathologic features of the tumor were well differentiated in 87%. The operative mortality was 8% and two patients died of recurrent disease one and three years postoperatively. One man is alive seven years postoperatively with recurrent disease. Nineteen patients (79%) are alive five to nine years following surgery with no evidence of disease. A comparison with patients with similarly staged Dukes' B and C disease shows a substantially improved survival at five years when extended operation is performed.