Recent Strategy of Surgery for Colonic Cancer

Abstract

Resected colonic cancer patients were divided into two groups by operative period : the first period (from 1977 to 1983) contained 267 patients and the latter period (from 1984 to 1990) 466 patients. The surgical effect for the patients of the latter period was compared with that of the first period. Cumlative 5-year survival rates of the first and the latter period were 65.2% and 74.7% respectively. There was statistically significant improvemant (p<0.05) in the cases of the latter period. In spite of this result, in CurA cases of any stage, there was no significant difference of prognosis between these two periods. This fact showed that surgical technique for colonic cancer had already been established in the first period. In Cur B cases of the latter period, the 5-year survival rate improved from 33.3% to 47.8%. This improvement may come from aggresive resection for metastatic lesions. Bacause of increased moderately differentiated adenocarcinoma and peritoneal dissemination in the latter period, there was no prognostic improvement in both stage IIIa and IIIb cases. Until now, our attention has been given to the therapy for hematogeneous metastases, but the time has come to treat seriously other types of cancer spreading (especially for peritoneal dissemination) in addition to hematogeneous cancer spreading.