Surgical treatment of metastatic colorectal adenocarcinoma

Ninety-one patients with recurrent or metastatic colorectal adenocarcinomas were studied according to the anatomic areas of the recurrent tumor. In Group A, 30 patients with anastomotic recurrence, diagnosis was made in the majority within two years from initial surgery; most of them had specific symptomatology. A significant number of patients had blood in the stools. In half of the patients, complete resection of the recurrent tumor was feasible. In Group B, 47 patients with intra-abdominal recurrence, there was some delay in diagnosis; the symptomatology was less specific, and fewer patients were rendered free of tumor following reresection. The medial survival and estimated five-year survival rate were, in both groups, strongly related to the completeness of the resection. In Group C, with distant metastasis (eight patients with pulmonary and six with liver metastasis), the disease-free interval was longer compared to the previous groups. The metastatic tumor was found in three patients, four or more years after the initial surgery. The medial survival was the same as in the two other subgroups with complete resection of the recurrent tumor.