Local recurrence following ‘curative’ surgery for large bowel cancer: II. The rectum and rectosigmoid

From 1966 through 1970 we performed resections in 216 patients with carcinoma of the large bowel. The relative five year survival for all patients was 65.5%. The relative five year survival for all potentially curable patients was 80.4%. Patients with positive lymph nodes and full-thickness penetration of their tumors had a five year survival of 70.5% and a 10 year survival of 60.5%. In performing this study we have tested the principles of wide anatomical resection and radical lymphadenectomy. For their specific influences on survival we have also examined stage, site, age, sex, race, margins, local recurrence, hypogastric lymph node dissection, serosal penetration and various aspects of nodal status. The information derived from these parameters has confirmed our hypothesis that survival is directly related to radical anatomical resection and lymphadenectomy. For rectal cancer, extensive resection also reduces the incidence of local recurrence. We are persuaded that the principles of operation for large-bowel cancer are valid and that they merit universal adoption.