2026-05-05T15:30:42.728Z http://ezaposleni.singidunum.ac.rs/rest/sciNaucniRezultati/oai

ezaposleni.singidunum.ac.rs/rest/sciNaucniRezultati/oai:2:5825 2018-04-26T11:18:17Z 2

ONCOLOGICAL OUTCOME AUDIT OF MULTIVISCERAL RESECTIONS FOR PRIMARY COLORECTAL CANCER: A SINGLE CENTRE EXPERIENCE 2018 http://ezaposleni.singidunum.ac.rs/rest/sciNaucniRezultati/oai/record/2/5825 I. Dimitrijevic G. Barišić V. Marković P. Gavrilović M. Bašić Z. Krivokapić Introduction. Colorectal cancer still presents a major health problem, with around 10% of patients, where tumor invades surrounding structures or organs. These patients usually are challenging to treat, even for experienced colorectal surgical team. The decision for performing multivisceral resection is often made intraoperatively, with no sufficient data on the tumor and patient condition. The percentage of perioperative morbidity and mortality is high and oncological outcome is often unfavorable. Methods. This was retrospective analysis of patients operated on the Department for Colorectal Surgery of the First Surgical Clinic, Clinical Centre of Serbia, Belgrade. En bloc multivisceral resection for the primary adenocarcinoma of the colon and rectum was uniformly performed. Data were collected in prospectively designed database. Follow-up period was minimum 2 years. Patients were analyzed in terms of patohystological, demographical and follow-up data. Survival and time to recurrence were evaluated using Kaplan-Meier method and the log-rank test. Results. 213 patients were included in the study The mean age was 59,9 ±12,0 years. Follow-up period was 33,8 ±29 months. Histopathology confirmed true tumor infiltration of the surrounding organ /structure in 126 patients (59,2%). The R0 resection was confirmed in 173 patients (81,2%). 5-year overall survival was 43,4%. 5-year survival for colon patients was 45,9% and in rectal cancer group 40,9%. In N0 group of patients, overall survival in 5-year period was 66,7%. N1 and N2 status proved adverse effect on survival (overall 5-year survival 31,3% and 15,9% respectively). 5-year local recurrence rate in R0 group of patients was 17,7% and the percentage of distant metastases in was 66,3% Conclusion. Multivisceral resections are demanding procedures, requiring highly specialized surgical team and high volume hospital. Oncological outcome of these procedures is still unfavorable. In cases with node positive disease or R1 resection perspective is poor. On the other hand, in absence of these unfavorable factors, we can expect good oncological outcome. More meticulous preoperative staging and aggressive preoperative treatment can further improve results. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III 41033: The role of preoperative staging, determining prognostic and therapeutic markers, objectification of functional results in the decision on the strategy of treatment of the rectal cancer with the aim to improve oncological treatment results and the quality of life] article 10.2298/VSP180101035D 35 56 0042-8450 Vojnosanitetski pregled (VSP)