[The results after extensive radical resection of locally advanced colorectal carcinoma]

The results of extended resections for locally advanced colorectal cancer and the factors influencing the long term survival and recurrence rate are analyzed in 69 patients. All of them underwent radical en-bloc resection including the primary tumor and the adjacent affected structures. The existence of tumoral invasion was confirmed in 42 cases (60%). In the remaining, inflammatory adhesions were presents. Overall 5 year survival did not show significant differences between the groups of patients with benign or malignant infiltration (71% y 51% respectively). Within the same tumor stage, the results were similar for the two types of infiltration. Significant differences were found when lymph nodes metastases were considered: 65% 5 year survival in patients with negative lymph nodes versus 35% in patients with positive nodes. The probability of metastases and tumor recurrence was significantly higher in the group with malignant infiltration. Patients with positive lymph nodes showed lower disease-free interval rate. These data show that long term control of the tumor in locally advanced colorectal carcinomas can be achieved by an aggressive surgical approach. The presence of lymph mode metastases is a more useful prognostic factor influencing survival and relapse rate that the local infiltration by it-self.