Assessment of Multivisceral Resection in Locally Advanced Colon Cancer in the Supracolic Abdominal Cavity: Who Benefits from Extended Surgery?
DOI:
https://doi.org/10.14748/tn88pt23Keywords:
pancreas resection, colorectal, advanced, multivisceralAbstract
Introduction:
Locally advanced colorectal cancer (LACRC) with infiltration into the organs in the supracolic abdominal cavity poses a serious surgical challenge. Approximately 10% of patients with primary colon cancer are diagnosed with T4 tumors invading adjacent structures such as the pancreas, duodenum, stomach, liver, and gallbladder. Achieving R0 resection is a key factor for long-term survival, often requiring extended multivisceral resection (EMR).
Aim:
The aim of this article is to present the experience of the Clinic of Hepatobiliary, Pancreatic, and General Surgery at Acibadem City Clinic Tokuda University Hospital with multivisceral resections in patients with locally advanced colorectal carcinoma with infiltration of organs in the supracolic abdominal cavity.
Materials and Methods:
A retrospective analysis was performed on 24 patients operated on between January 2014 and December 2022. All patients had locally advanced colorectal carcinoma without distant metastases and underwent multivisceral resection for radical tumor removal.
Results:
The mean age of the patients was 66.3 years (range: 45–81), with a predominance of men—66.7%. The most commonly infiltrated organ was the stomach, in 10 patients (41.7%), followed by the duodenum in 5 cases (20.8%), the pancreas in 4 cases (16.7%), the gallbladder in 3 cases (12.5%), and the liver in 2 cases (8.3%). A 30-day mortality rate was reported in 1 patient (4.2%), and the overall complication rate was 37.5%. Survival rate over 24 months was observed in 62.5% of patients.
Discussion:
The results confirm the need for an aggressive surgical strategy in patients with advanced colorectal carcinoma infiltrating organs in the supracolic abdominal floor. Previous studies have also demonstrated a better prognosis in patients with pT4 tumors undergoing EMR. In specialized centers, a multidisciplinary approach significantly reduces the operative risk and increases oncological effectiveness.
Conclusion:
Multivisceral resection is a justified and effective approach in patients with LACRC with infiltration of adjacent organs. The results of our study, conducted at Acibadem City Clinic Tokuda University Hospital, support this approach in carefully selected patients.
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