Multivisceral resection of locally advanced colorectal cancer in an African referral centre.
Journal
South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie
ISSN: 2078-5151
Titre abrégé: S Afr J Surg
Pays: South Africa
ID NLM: 2984854R
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
entrez:
10
7
2020
pubmed:
10
7
2020
medline:
20
5
2021
Statut:
ppublish
Résumé
Colorectal cancer (CRC) is common and often presents with advanced disease in Africa. Multivisceral resection (MVR) improves survival in locally advanced (T4b) CRC. The aim was to describe the management and outcomes of patients with clinical T4b CRC without metastatic disease who underwent MVR. A retrospective review of patients with T4 CRC who underwent MVR between January 2008 and December 2013. Four hundred and ninety-four patients were included. Of the 158 with suspected T4 cancer, 44 had MVR, of which one was excluded due to metastases. The mean age was 64 years. The male to female ratio was 1:1. The most commonly resected extra-colorectal structure was the abdominal wall (21%). The median survival was 68 months (SD 13.9). The 5-year disease free (DFS) and overall survival (OS) were 46% and 55%, respectively. Survival of patients with colon and rectum cancer was similar. Intraoperative tumour spillage, vascular/perineural invasion, and anastomotic leakage were independent predictors of survival. Multivisceral resection of locally advanced (T4b) CRC is feasible in the African context. Complete resection improves survival and should be the goal.
Sections du résumé
BACKGROUND
BACKGROUND
Colorectal cancer (CRC) is common and often presents with advanced disease in Africa. Multivisceral resection (MVR) improves survival in locally advanced (T4b) CRC. The aim was to describe the management and outcomes of patients with clinical T4b CRC without metastatic disease who underwent MVR.
METHODS
METHODS
A retrospective review of patients with T4 CRC who underwent MVR between January 2008 and December 2013.
RESULTS
RESULTS
Four hundred and ninety-four patients were included. Of the 158 with suspected T4 cancer, 44 had MVR, of which one was excluded due to metastases. The mean age was 64 years. The male to female ratio was 1:1. The most commonly resected extra-colorectal structure was the abdominal wall (21%). The median survival was 68 months (SD 13.9). The 5-year disease free (DFS) and overall survival (OS) were 46% and 55%, respectively. Survival of patients with colon and rectum cancer was similar. Intraoperative tumour spillage, vascular/perineural invasion, and anastomotic leakage were independent predictors of survival.
CONCLUSION
CONCLUSIONS
Multivisceral resection of locally advanced (T4b) CRC is feasible in the African context. Complete resection improves survival and should be the goal.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
64-69Informations de copyright
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