Effect of extended radical resection for rectal cancer

AIM: To discuss the rationality of extended radical resection (ERR) and to guide the surgical treatment of rectal cancer. METHODS: Total 211 patients who underwent ERR from 1981 to 1987 (follow-up rate of 94.8 %) were selected to study the patterns of lymphatic metastasis and therapeutic effect. The control group was made of 293 patients with rectal cancer who underwent conventional radical resection (CRR) and its follow-up rate was 98.5 %. The lymph node specimens, obtained by the triple-approach lymph node resection during the radical resection of rectal cancer, were studied by conventional pathological method. The extended radical resection, guided by the patterns of lymphatic metastasis, was applied in the clinical practice. RESULTS: The incidence of lymphatic metastasis in Chinese patients with advanced rectal cancer was 43.6 %, and that of the upper 2nd and 3rd groups and the lateral group was 14.2 %, 10.9 % and 11 % respectively. The 5,10-year-survival rates of the ERR were 68.0 % and 47.0 %, respectively, which were much higher than those of the conventional radical resection (42.9 % and 25.3 %). CONCLUSION: The ERR for rectal cancer removes all the lymph nodes, prevents possible metastasis and finally improves the survival rate.