The effectiveness of wide anatomical resection and radical lymphadenectomy for patients with rectal cancer.

The results of wide anatomical resection and radical lymphadenectomy which we termed the extended operation were examined. Materials consisted of 160 Japanese patients who underwent conventional operation during 1962-1968 prior to the introduction of extended operation, 113 patients who underwent extended operation since 1969, and 119 patients who underwent conventional operation from 1969 to 1976. The cumulative 5-year survival rates were 70% (1962-1968) and 67.8% (1969-1976) for the conventional operation groups and 90.3% for the extended operation group in Dukes B group (p less than 0.05). In Dukes C group, the rates were 26.3% (1962-1968) and 37.8% (1969-1976) for the conventional operation groups and 51.6% for the extended operation group. The incidences of local recurrence in Dukes B group were 25% (1969-1976) in the conventional operation group and 6.5% in the extended operation group, while in Dukes C group the rates were 45.0% (1969-1976) and 25% respectively. Our study demonstrated that the extended operation resulted in a decrease in the local recurrence of rectal cancer and prognosis. We therefore recommend that extensive surgery be planned for advanced cases of rectal cancer.