Short-term outcome and survival after multiorgan resection for locally advanced colo-rectal cancer. Identification of risk factors

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COD: 03_2018_07_2790 Categorie: ,

Adrian Bartos¸, Dana Bartos¸, Raluca Stoian, Bianca Szabo, Cristian Cioltean,
Ioana Iancu, Calin Molnar, Nadim Al Hajjar, Cosmin Puia, Cornel Iancu,
Caius Breazu

Ann. Ital. Chir., 2018 89, 3: 223-228

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INTRODUCTION: Although multi-organ resections (MOR) are recommended by international guidelines for advanced colorectal
cancer, the literature shows that the morbidity and mortality that accompanies these complex interventions limits
the number of patients receiving this treatment.
The purpose of our study was to analyse the immediate and remote results obtained after MOR and to identify potential
factors that might influence the outcome.
MATERIAL AND METHOD: Our study is a retrospective cohort which included patients surgically treated in our service
for locally advanced colorectal cancer. We excluded patients with hepatic metastatic tumors and those who needed pelvic
exenteration. Between 2006 and 2010, in our service, have been treated with MOR 146 patients, 107 being included
in our study. We analysed morbidity, mortality and survival after MOR and the factors that could have influenced
the postoperative course.
RESULTS: Identified risk factors that negatively influenced the postoperative outcome were: diabetes, personal neoplastic
pathologies, associated cardiovascular disease, history of major surgeries, intraoperative blood loss, number of resected organs.
Survival was negatively influenced by positive resection margins, the presence of lymph node metastases and the presence
of complications in the postoperative period.
CONCLUSIONS: The data of this study support the indication for routine MOR for patients diagnosed with locally advanced
colorectal cancer with the condition that R0 resection margins are achieved.
All mentioned above underline the importance of the experience that the surgical team has in this type of surgeries, in
order to achieve optimum results. This experience must concern the preoperative management, surgical technique and
postoperative care.