A multiparametric computer analysis of carcinoma of the colon

From 1957 to 1973, 656 patients with carcinoma of the entire colon, excluding those with carcinoma of the rectum, were reviewed with the aid of a computer. Of 457 patients, 69.7 per cent were observed for a minimum of five years. Sixty-five per cent of the lesions were located in the cecum or sigmoid colon. In patients with type A lesion, the five year plus survival rate was 71.15 per cent while, in patients with type D lesions, the five year plus survival rate was zero per cent. Patients who presented with intestinal obstruction had a significantly lower five year survival rate. Roentgenographic visualization of the cecum was significantly less accurate in demonstrating carcinoma when compared with that of the sigmoid colon. An emergency surgical procedure had a significantly higher operative mortality than did elective procedures. In both groups of patients undergoing emergency and elective operations, primary resection and anastomosis led to similar operative mortality rates, although staged procedures resulted in the lowest operative mortality in both groups. In the group of patients who had elective operations, resection an primary anastomosis led to a significantly lower wound infection and fistula rate when compared with the group of patients who had emergency procedures. In comparison with other series, no improvement in survival was illustrated in patients with carcinoma of the colon. The use of new modalities of adjuvant therapy, such as radiotherapy or chemotherapy, or both, actually should be evaluated.