Survival after en bloc resection for locally invasive colorectal carcinoma

Five percent of colorectal carcinomas invade contiguous structures at the time of primary surgical therapy. This study was designed to evaluate the survival of patients treated with en bloc resection of locally invasive colorectal cancer specifically regarding intraoperative decision-making. No difference was noted in either survival or recurrence on the basis of the site of primary disease or secondary structure resected. No patient with locally invasive colorectal carcinoma associated with nodal metastases (stage C3) remained free of disease and there were no 5-year survivors. In contrast, the 5-year survival of patients with local invasion and no lymph node metastases (stage B3) was 69%. In the absence of lymph node metastases, en bloc resection of primary colorectal carcinoma and locally invaded adjacent viscera offers survival equivalent to that of patients without local invasion, but functions only to prevent local recurrence in patients with lymph node metastases.