Prognostic and therapeutic observations of manifestations in the genitourinary tract of adenocarcinoma of the colon and rectum.

To evaluate the significance of involvement of the genitourinary tract in adenocarcinoma of the colon and rectum, we received the records of 178 patients with adenocarcinoma of the colon and rectum admitted to the University of Massachusetts Medical Center from 1980 to 1985. Sixty-eight patients (38 per cent) had urologic manifestations categorized as ureteral obstruction or injury (34 per cent), invasion to the bladder or prostate, or both (10 per cent), isolated gross hematuria (18 per cent), radiation cystitis (6 per cent) and neurogenic bladder (26 per cent). Involvement of the genitourinary tract was more common among patients with recurrent versus primary carcinoma (53 versus 32 per cent) and among patients with high stage (Dukes' C and D) versus low stage (Dukes' A and B) carcinoma (48 versus 21 per cent). The survival rate was worse in patients with high stage compared with low stage disease and no patient with recurrent high stage disease survived beyond three years. Short term survival (less than two years) was not statistically different among patients with or without manifestations in the genitourinary tract: 63 and 45 versus 71 and 66 per cent at one and two years, respectively; however, the five year survival rate was worse among patients with genitourinary involvement (30 versus 54 per cent, p less than 0.05). Surgical and endoscopic intervention of the urinary tract was performed upon 36 patients with Dukes' C and D carcinoma because of life-threatening sepsis or azotemia, or both.(ABSTRACT TRUNCATED AT 250 WORDS)