Operative therapy and prognosis of rectum carcinoma patients not curatively resectable. Results of a multicenter study of the Study Group Colorectal Carcinoma (SGCRC)

The prospective multicenter observation study of the SGCRC found in 1121 rectal carcinomas a resection rate of 94.2 % with 79.1 % curative resections (R0), 3.1% R1 resections and 11.7 % R2 resections. The reasons for non-curative resections were multimorbidity preventing tumor resection, distant metastasis or locally advanced primary tumors. The prognosis following non curative surgery for rectum carcinoma depends on resectability, synchrone distant metastases and R classification (according to UICC). Additional therapy (chemo- and radiotherapy) may improve short time survival after non-curative resections in presence of distant metastases. After non-resective surgery local tumor destruction (laser, kryotherapy) is possibly an useful additional therapy. The indications for multimodal therapies are discussed and the development of uniform therapeutical strategies is required.