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Surgery for Recurrent Colon Cancer
- Richard M. Goldberg, MD;
- Thomas R. Fleming, PhD; and
- Catherine M. Tangen, PhD
- Mayo Clinic; Rochester, MN 55905 (Goldberg) University of Washington; Seattle, WA 98195 (Fleming and Tangen)
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IN RESPONSE:
Dr. Sugarbaker describes his experience treating patients with peritoneal recurrence of colon carcinoma by using aggressive surgery followed by intraperitoneal mitomycin C and 5-fluorouracil. He reports a 5-year survival rate of 40% for the 45 patients who could undergo complete excision of their tumors. Our study sample did not receive any specified therapy after surgical resection of tumors for peritoneal carcinomatosis or any other type of recurrence. Therefore, we can make no specific judgment about the value of such therapy on the basis of our series. However, strategies that combine treatments, such as intraperitoneal chemotherapy or intraoperative radiation therapy, must be investigated to improve the outcomes for such patients. We certainly encourage further research into more successful strategies for such patients.
Dr. Bagley expresses concern that we have overstated our outcomes for patients with hepatic metastases and local recurrence of colorectal cancer. Obviously, we are concerned about accurately reporting our findings. We also hope that physicians who cite our article will do so accurately. One of the ways that we attempted to ensure this was in the title of our paper: “Surgery for Recurrent Colon Cancer: Strategies for Identifying Resectable Recurrence and Success Rates after Resection.” We hope that this clearly stated title will indicate to physicians who wish to refer to this paper, as well as those who read the paper, that the study sample we focused on consisted of patients with resectable recurrence and that we were looking at success rates after resection. It was for this reason that we chose to report the percentages of curative surgeries only on patients who could have resection with curative intent. We certainly did not mean to overstate our outcomes.
- Copyright ©2004 by the American College of Physicians
