Carcinoma of the colon and rectum is the second leading cause of death from neoplastic disease in the United States. A distressing aspect of this disease is that, in the main, the five-year survival rates following curative resections have not improved significantly over the past decade or two.1,2 Whatever increased survival has occurred generally can be attributed to decreased operative mortality rather than improved therapy. Several refinements in technique, such as bowel stump ligation to prevent anastomotic tumor cell implantation3 and the notouch isolation technique,4 have been described recently; but, except for their possible benefit, the survival data reported by all authors has been uniform.1,2,4,5 Clearly, there is a marked reduction in the five-year survival from 70% to 80% to approximately 40% when a tumor metastasizes to the regional lymph nodes (Duke's C), and a lesser reduction to 50% to 60% when the tumor extends through
Mackman S, Curreri AR, Ansfield FJ. Second-Look Operation for Colon Carcinoma After Fluorouracil Therapy. Arch Surg. 1970;100(4):527–531. doi:10.1001/archsurg.1970.01340220203034
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