Abstract
The complete autopsies of 145 patients dying of colorectal cancer are reviewed. Isolated local or distant metastases are infrequent, compared to disseminated disease. Solitary local recurrences are most common after resection of rectal tumors. Right colon tumors spread to local and distant sites in 90% of autopsies, and to distant sites alone in 10%. Rectal tumors spread locally only in 25% of cases, to distant site alone in 25%, and to both in 50%. Regardless of the origin of the primary tumor, the liver is the most common site of metastasis, followed by the regional lymph nodes and the lungs. Two-thirds of the patients with right colon lesions died of liver metastases, and three-quarters of those with rectal tumors succumbed to disseminated disease. The current curative and palliative treatment of recurrent colorectal cancer in clinical medicine by surgery, radiotherapy, and chemotherapy is reviewed. It is suggested that an understanding of the anatomic patterns of cancer recurrence will increase in importance as advances in the modalities of treatment are made,
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- Abrams M. S., Lerner H. J. Survival of patients at Pennsylvania Hospital with hepatic metastases from carcinoma of the colon and rectum. Dis Colon Rectum. 1971 Nov-Dec;14(6):431–434. doi: 10.1007/BF02553467. [DOI] [PubMed] [Google Scholar]
- Cahan W. G., Castro E. B., Hajdu S. I. Therapeutic pulmonary resection of colonic carcinoma metastatic to lung. Dis Colon Rectum. 1974 May-Jun;17(3):302–309. doi: 10.1007/BF02586970. [DOI] [PubMed] [Google Scholar]
- Cass A. W., Million R. R., Pfaff W. W. Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum. Cancer. 1976 Jun;37(6):2861–2865. doi: 10.1002/1097-0142(197606)37:6<2861::aid-cncr2820370643>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
- Cedermark B. J., Blumenson L. E., Pickren J. W., Holyoke D. E., Elias E. G. Ths significance of metastases to the adrenal glands in adenocarcinoma of the colon and rectum. Surg Gynecol Obstet. 1977 Apr;144(4):537–546. [PubMed] [Google Scholar]
- DIONNE L. THE PATTERN OF BLOOD-BORNE METASTASIS FROM CARCINOMA OF RECTUM. Cancer. 1965 Jun;18:775–781. doi: 10.1002/1097-0142(196506)18:6<775::aid-cncr2820180615>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
- FLOYD C. E., CORLEY R. G., COHN I., Jr LOCAL RECURRENCE OF CARCINOMA OF THE COLON AND RECTUM. Am J Surg. 1965 Feb;109:153–159. doi: 10.1016/s0002-9610(65)80138-6. [DOI] [PubMed] [Google Scholar]
- GREEN W. W., BLANK W. A. Perine 1 recurrence after abdominoperineal resection of carcinoma of the rectum. Dis Colon Rectum. 1963 Mar-Apr;6:125–129. doi: 10.1007/BF02633465. [DOI] [PubMed] [Google Scholar]
- Gilbertsen V. A. Adenocarcinoma of the Rectum: Incidence and Locations of Recurrent Tumor Following Present-day Operations Performed for Cure. Ann Surg. 1960 Mar;151(3):340–348. doi: 10.1097/00000658-196003000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gunderson L. L., Sosin H. Areas of failure found at reoperation (second or symptomatic look) following "curative surgery" for adenocarcinoma of the rectum. Clinicopathologic correlation and implications for adjuvant therapy. Cancer. 1974 Oct;34(4):1278–1292. doi: 10.1002/1097-0142(197410)34:4<1278::aid-cncr2820340440>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
- Higgins G. A., Humphrey E., Juler G., LeVeen H. H., McCaughan J., Keehn R. J. Adjuvant chemotherapy in the surgical treatment of large bowel cancer. Cancer. 1976 Oct;38(4):1461–1467. doi: 10.1002/1097-0142(197610)38:4<1461::aid-cncr2820380402>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
- Manson P. N., Corman M. L., Coller J. A., Veidenheimer M. C. Anastomotic recurrence after anterior resection for carcinoma: Lahey Clinic experience. Dis Colon Rectum. 1976 Apr;19(3):219–224. doi: 10.1007/BF02590906. [DOI] [PubMed] [Google Scholar]
- Mavligit G. M., Gutterman J. U., Burgess M. A., Khankhanian N., Seibert G. B., Speer J. F., Jubert A. V., Martin R. C., McBride C. M., Copeland E. M. Prolongation of postoperative disease-free interval and survival in human colorectal cancer by B.C.G. or B.C.G. plus 5-fluorouracil. Lancet. 1976 Apr 24;1(7965):871–876. doi: 10.1016/s0140-6736(76)92093-6. [DOI] [PubMed] [Google Scholar]
- Moossa A. R., Ree P. C., Marks J. E., Levin B., Platz C. E., Skinner D. B. Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum and rectosigmoid. Br J Surg. 1975 Sep;62(9):727–730. doi: 10.1002/bjs.1800620913. [DOI] [PubMed] [Google Scholar]
- Morson B. C., Vaughan E. G., Bussey H. J. Pelvic Recurrence after Excision of Rectum for Carcinoma. Br Med J. 1963 Jul 6;2(5348):13–18. doi: 10.1136/bmj.2.5348.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nystrom J. S., Viola M. V. Adjuvant treatment of cancer I. Large bowel cancer. Conn Med. 1977 May;41(5):265–270. [PubMed] [Google Scholar]
- Patt D. J., Brynes R. K., Vardiman J. W., Coppleson L. W. Mesocolic lymph node histology is an important prognostic indicator for patients with carcinoma of the sigmoid colon: an immunomorphologic study. Cancer. 1975 May;35(5):1388–1396. doi: 10.1002/1097-0142(197505)35:5<1388::aid-cncr2820350523>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
- Shindo K. Recurrence of carcinoma of the large intestine. A statistical review. Am J Proctol. 1974 Jun;25(3):80–90. [PubMed] [Google Scholar]
- TAYLOR F. W. Cancer of the colon and rectum: A study of routes of metastases and death. Surgery. 1962 Aug;52:305–308. [PubMed] [Google Scholar]
- TYNDAL E. C., DOCKERTY M. B., WAUGH J. M. PELVIC RECURRENCE OF CARCINOMA OF THE RECTUM. Surg Gynecol Obstet. 1964 Jan;118:47–51. [PubMed] [Google Scholar]
- WANG C. C., SCHULZ M. D. The role of radiation therapy in the management of carcinoma of the sigmoid, rectosigmoid, and rectum. Radiology. 1962 Jul;79:1–5. doi: 10.1148/79.1.1. [DOI] [PubMed] [Google Scholar]
- WELIN S., YOUKER J., SPRATT J. S., Jr THE RATES AND PATTERNS OF GROWTH OF 375 TUMORS OF THE LARGE INTESTINE AND RECTUM OBSERVED SERIALLY BY DOUBLE CONTRAST ENEMA STUDY (MALMOE TECHNIQUE). Am J Roentgenol Radium Ther Nucl Med. 1963 Oct;90:673–687. [PubMed] [Google Scholar]
- Welch J. P., Donaldson G. A. Detection and treatment of recurrent cancer of the colon and rectum. Am J Surg. 1978 Apr;135(4):505–511. doi: 10.1016/0002-9610(78)90028-4. [DOI] [PubMed] [Google Scholar]
- Whiteley H. W., Jr, Stearns M. W., Jr, Leaming R. H., Deddish M. R. Palliative radiation therapy in patients with cancer of the colon and rectum. Cancer. 1970 Feb;25(2):343–346. doi: 10.1002/1097-0142(197002)25:2<343::aid-cncr2820250210>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
- Wilkins E. W., Jr, Head J. M., Burke J. F. Pulmonary resection for metastatic neoplasms in the lung. Experience at the Massachusetts General Hospital. Am J Surg. 1978 Apr;135(4):480–483. doi: 10.1016/0002-9610(78)90023-5. [DOI] [PubMed] [Google Scholar]
- Winchester D. P., McBride C. M. Cancer of the colon: a comparison of survival factors. South Med J. 1974 Sep;67(9):1025–1030. doi: 10.1097/00007611-197409000-00006. [DOI] [PubMed] [Google Scholar]