title: Multivisceral and standard resections in colorectal cancer.
abstract: OBJECTIVE
  The current study was designed to identify prognostic factors for long-term survival in patients with advanced colorectal cancer in a consecutive cohort.
  
  
  METHODS
  A total of 123 patients were operated because of T4 colorectal cancer between 1 January 2002 and 31 December 2008 in the Clinic of Surgery, UK-SH Campus Luebeck.
  
  
  RESULTS
  A total of 78 patients underwent a multivisceral resection. The postoperative morbidity was elevated in the patient group with multivisceral resections (34.6% vs. 26.7%). Nevertheless, we detected no significant differences concerning 30 days mortality (7.7% vs. 8.9%; p = 0.815). The main prognostic factor that reached significance in the multivariate analysis was the possibility to obtain a R0 resection (p < 0.0001) resulting in a 5-year survival rate of 55% for patients with curative resection. There were no statistically significant differences in 5-year survival between multivisceral and non-multivisceral resections (p = 0.608). Also we were not able to detect any significant differences for cancer of colonic or rectal origin (p = 0.839), for laparoscopic vs. open procedures (p = 0.610), and for emergency vs. planned operations (p = 0.674). Moreover, the existence of lymph node metastases was not a predictive factor concerning survival as there was no difference between patients with and without lymph node metastases (p = 0.658).
  
  
  CONCLUSIONS
  Multivisceral resections are associated with the same 5-year survival as standard resections. Therefore, the aim to perform a R0 resection should always be the main goal in surgery for colorectal cancer. In planned operations, a laparoscopic approach is justified in selected patients.
authors.affiliation: Clinic of Surgery, University Clinic of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany. drmartinhoffmann@googlemail.com
authors.forename: Martin
authors.initials: M
authors.lastname: Hoffmann
authors.forename: Carmen
authors.initials: C
authors.lastname: Phillips
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Oevermann
authors.forename: Claudia
authors.initials: C
authors.lastname: Killaitis
authors.forename: Uwe-Johannes
authors.initials: UJ
authors.lastname: Roblick
authors.forename: Philipp
authors.initials: P
authors.lastname: Hildebrand
authors.forename: Conny Georg
authors.initials: CG
authors.lastname: Buerk
authors.forename: Heike
authors.initials: H
authors.lastname: Wolken
authors.forename: Peter
authors.initials: P
authors.lastname: Kujath
authors.forename: Erik
authors.initials: E
authors.lastname: Schloericke
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bruch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications; D011379:Prognosis; D015996:Survival Rate; D014781:Viscera / Q000601:surgery*