The results of surgical treatment of cancer of the colon at the Cleveland Clinic from 1965-1975: classification of the spread of colon cancer and long-term survival.

Between the years 1965-1975, 564 patients underwent surgical treatment for cancer of the colon. The primary tumour was removed in 502 patients (89%) in all cases with a "no touch isolation" technique. The 5-year survival rate corrected for age was 64% in 546 operative survivors, and 82% in 413 patients operated with intent to cure. Survival analyses are presented classifying the spread of the tumour by the clinico-pathological method of Turnbull, the TNM method, the Astler-Coller method, Dukes' method. The results suggest that the Astler-Coller classification offers no advantage over that of Dukes' when predicting survival for patients after operation for cure, and that separating those patients considered to have evidence of invasion of an adjacent organ at operation (Turnbull's classification) from those patients without evidence of contiguous growth, is only justified if invasion of cancer is confirmed by histological examination of the resected specimen.