Therapeutic Approach in Locally Advanced Colon Tumours (T4NxM0) - Clinical Experience in 18 Consecutive Cases
M. Marincaş, C. Cirimbei, V. Prunoiu, L. Lucenco, R. Buzatu, S. Ionescu, D. Mihaila, I. Stefan, E. BrătucuOriginal article, no. 1, 2014
Introduction: Surgery holds a central seat in the treatment ofcolon cancer, its objective being R0 resection. Chemotherapyand an appropriate oncological follow-up complete thetreatment.Aim: To establish an adequate therapeutic conduct in patientswith advanced colon tumours, with no hepatic metastases.Material and Method: retrospective study on a group of 150patients with colon neoplasm treated in the First SurgeryClinic of the Bucharest Oncology Institute in Bucharest,between 01 01 2008 -01 03 2013.Results: 18 patients presented locally extended colon tumourswhich required multivisceral resections. Patients with hepaticmetastases were excluded from the study. The most frequentlyaffected organs were: the small bowel and the internal genitalorgans, followed by the urinary bladder, spleen, duodenum anddiaphragm muscle. Patients were oncologically followed-upaccording to current protocols and submitted to chemotherapy.When a maximum response was reached in R2 patients orwhen recurrence occurred in R0 and R1 patients, surgicalintervention was required. When necessary, the operation wasperformed by multidisciplinary teams. 5 patients died due to local recurrence, disease progression, metastatic disease, andalso due to comorbidities.Conclusion: Treatment applied by oncological committeesand multidisciplinary surgical teams, along with correctoncological follow-up and surgical reintervention whenmaximum response to chemotherapy was reached in R2 orwhen recurrences occurred in R0 and R1 patients representsthe adequate therapeutic conduct in patients with locallyadvanced colon tumours.
