Long-term results of combined treatment of colorectal cancer

Colorectal cancer is one of the leading causes of worldwide cancer mortality.Its incidence in Eastern Europe has been growing systematically with the changes in life style adopted from the West.M a t e r i a l a n d m e t h o d.The analysis was based on a prospective study of 1332 patients operated on for primary colorectal cancer at the 1 st Department of General and GI Surgery in Cracow, Poland, between the years 1984 and2000.The same study protocol was applied to all patients included in the study.R e s u l t s.In the group of 1332 operated patients, 1262 underwent resective operations, and in the remaining 70 cases palliative procedures, such as intestinal by-pass, colostomy or explorative surgery without tumor removal were performed.96.3% and 93.2% resective procedures were performed in the colon and the rectal cancer group, respectively.Five-year survival rates after resection were as follows (p<0.001):86.3% for stage I colorectal cancer, 68.7% for stage II, 47.5% for stage III, and 7% for stage IV.Chemotherapy administered to patients with colorectal cancer prolonged both survival and the recurrence-free period.The results were statistically significant in the groups with stage II (p=0.04) and III (p=0.05)colon cancer.In stage IV colon cancer systemic chemotherapy prolonged patient survival, but failed to achieve statistical significance.In stage II and III rectal cancer, systemic chemotherapy prolonged patient survival , however statistically significant differences were found for stage III rectal cancer acc. to UICC/AJCC.In both colon and rectal cancers chemotherapy had no effect on the recurrence-free period.C o n c l u s i o n.We conclude that extended lymphadenectomy and multivisceral resection is extremely important for the curative outcome, also one cannot deny the importance of careful planning of the extent of colorectal surgery, including decisions concerning the endpoints.Combined treatment of colorectal cancer improves long term results.