Multivisceral resection of locally advanced colorectal cancer in an African referral centre

Abstract

Background: Colorectal cancer (CRC) is common and often presents with advanced disease in Africa. Multivisceral resection (MVR) improves survival in  locally advanced (T4b) CRC. The aim was to describe the management and outcomes of patients with clinical T4b CRC without metastatic disease who  underwent MVR.

Methods: A retrospective review of patients with T4 CRC who underwent MVR between January 2008 and December 2013.

Results: Four hundred and  ninety-four patients were included. Of the 158 with suspected T4 cancer, 44 had MVR, of which one was excluded due to metastases. The mean age was  64 years. The male to female ratio was 1:1. The most commonly resected extra-colorectal structure was the abdominal wall (21%). The median survival  was 68 months (SD 13.9). The 5-year disease free (DFS) and overall survival (OS) were 46% and 55%, respectively. Survival of patients with colon and  rectum cancer was similar. Intraoperative tumour spillage, vascular/perineural invasion, and anastomotic leakage were independent predictors of  survival.

Conclusion: Multivisceral resection of locally advanced (T4b) CRC is feasible in the African context. Complete resection improves survival and  should be the goal.