Abstract
The grim surgical reality that accompanies colorectal cancer resection suggests that approximately 50% of patients who come to the surgeon with a contained malignancy have this cancer converted to a disseminated disease process. Flawed surgical technology causes a surgically induced dissemination of microscopic residual disease in a large percentage of patients. Inadequate exposure, imperfect hemostasis, inadequate lymphadenectomy, and qualitatively poor margins of excision lead to the spillage of cancer cells in 30–50% of patients. Minor technical changes in the surgical approach to this disease can make a great difference in survival. The goal of cancer surgery for large bowel cancer is complete clearance and containment. Surgeons must believe that they are the most important prognostic variables before finding the commitment required to modify the current surgical approach.
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References
Turnbull RB, Kyle K, Watson FR, and Spratt J. Cancer of the colon: the influence of the no-touch isolation technic on survival rates. Ann. Surg., 166 (3) (1967) 420–427.
Phillips RKS, Hittinger R, Blesovsky L, Fry JS, and Fielding LE. Local recurrence following “curative” surgery for large bowel cancer: I. The overall picture. Br. J. Surg., 71 (1984) 12–16.
McArdle CS and Hole D. Impact of variability among surgeons on postoperative morbidity and mortality and ultimate survival. Br. J. Surg., 302 (1991) 1501–1505.
Hermanek P, Wieblet H, Staimmer D, Riedl S, and the German Study Group Colo-Rectal Carcinoma (SGCRC). Prognostic factors of rectum carcinoma-experience of the German multicentre study SGCRC. Tumori, 81(Suppl.) (1995) 60–64.
Holm T, Johansson H, Cedermark B, Ekelund, G, and Rutqvist LE. Influence of hospital-and surgeon-related factors on outcome after treatment of rectal cancer with or without preoperative radiotherapy. Br. J. Surg., 84 (1997) 657–663.
Porter GA, Soskolne CL, Yakimets WW, and Newman SC. Surgeon-related factors and outcome in rectal cancer. Ann. Surg., 227 (2) (1998) 157–167.
Anthone G, Brophy M, Fals J, Vukasin P, Ortega A, Ross R, et al. Does designated surgical interest improve the surgical management of colorectal cancer? Work done at University of Southern California. Annual Meeting of the American Society of Colon and Rectal Surgeons, 1998.
Averbach AM, Jacquet P, and Sugarbaker PH. Surgical technique and colorectal cancer: impaction on local recurrence and survival. Tumori, 81 (Suppl.) (1995) 65–71.
Scott N, Jackson P, Al-Jaberi, Dixon MF, Quirke P, and Finan PJ. Total mesorectal excision and local recurrence: A study of tumour spread in the mesorectum distal to rectal cancer. Br. J. Surg., 82 (1995) 1031–1033.
Heald RJ and Ryall RDH. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet,i (1986) 1479–1482.
Gunderson LL and Sosin H. Areas of failure found at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum: clinicopathologic correlation and implications for adjuvant therapy. Cancer, 34 (1974) 1278–1292.
Pickren JW, Tsukada Y, and Lane WW. Liver metastasis: analysis of autopsy data. In Liver Metastasis. Weiss L and Gilbert HA (eds.), GK Hall, Boston, 1982, pp 2–18.
Lofgren EP, Waugh JM, and Dockerty MB. Local recurrence of carcinoma after anterior resection of the rectum and the sigmoid. Arch. Surg., 74 (1957) 825–838.
Cole WH, Roberts SS, and Strehl FW. Modern concepts in cancer of the colon and rectum. Cancer, 19 (1966) 1347–1358.
Sugarbaker PH, Gianola FJ, Speyer JL, Wesley R, Barofsky I, and Meyers CE. Prospective randomized trial of intravenous versus intraperitoneal 5-fluorouracil in patients with advanced primary colon or rectal cancer. Surgery, 98 (1985) 414–421.
Sugarbaker PH. Laser-mode electrosurgery. In Peritoneal Carcinomatosis: Principles of Management. Sugarbaker PH (ed.), Kluwer, Boston, 1996, pp. 375–386.
Sugarbaker PH. Peritoneal carcinomatosis, sarcomatosis and mesothelioma. Surgical responsibilities. In Surgical Oncology Multidisciplinary Approach to Difficult Problems. Silverman H and Lieberman AW (eds.), Arnold, NY, 2002, pp. 175–205.
Sugarbaker PH. Peritonectomy procedures. Ann. Surg., 221 (1995) 29–42.
Sugarbaker PH (ed.). Intraperitoneal Chemotherapy and Cytoreductive Surgery: A Manual for Physicians and Nurses, 3rd ed. Ludann Company, Grand Rapids, Michigan, 1998.
Pestieau SR and Sugarbaker PH. Treatment of primary colon cancer with peritoneal carcinomatosis: A comparison of concomitant versus delayed management. Dis. Colon Rectum, 43 (2000) 1341–1348.
Sugarbaker PH. Peritoneal carcinomatosis: natural history and rational therapeutic interventions using intraperitoneal chemotherapy. In Peritoneal Carcinomatosis: Drugs and Diseases. Sugarbaker PH (ed.), Kluwer, Boston, 1996, pp. 149–168.
Gomez Portilla A, Sugarbaker PH, and Chang D. Second-look surgery after cytoreductive and intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer: analysis of prognostic features. World J. Surg., 23 (1) (1999) 23–29.
Esquivel J and Sugarbaker PH. Elective surgery in recurrent colon cancer with peritoneal seeding: when to and when not to operate (editorial). Cancer Therapeut., 1 (1998) 321–325.
Sugarbaker PH. Successful management of microscopic residual disease in large bowel cancer. Cancer Chemother. Pharmacol., 43(Suppl.) (1999) S15 - S25.
Saltz LB, Cox JV, Blanke C, Rosen LS, Fehrenbacher L, Moore MJ, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N. Engl. J. Med., 343 (2000) 905–914.
Stephens AD and Sugarbaker PH. Morbidity and mortality of cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy with mitomycin C using the coliseum technique. Ann. Surg. Oncol., 6 (8) (1999) 790–796.
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Sugarbaker, P.H. (2002). Surgical Management of Peritoneal Surface Spread of Colorectal Cancer. In: Saltz, L.B. (eds) Colorectal Cancer. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-160-2_22
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DOI: https://doi.org/10.1007/978-1-59259-160-2_22
Publisher Name: Humana Press, Totowa, NJ
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Online ISBN: 978-1-59259-160-2
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