The surgical treatment cases of 452 colorectal cancer patients at Tsuchiura Kyodo Hospital in the years 1973-87 were analyzed and the following results were obtained.
1) Operative cases of colorectal cancer have increased among the elderly. There was no difference between men and women. Recently, elder patients have been increasing with the advent of an aging society.
2) Survival prospects were better for women and younger patients.
3) There were no deaths in patients below 53 years of age. A high post-operative mortality rate was found in non-resectable cases.
4) Survival was significantly related to involvement of lymph nodes. Significant difference was recognized between the lymph node metastasis of n0 and n1. It showed good correlations with lymphtic invasion. Histological stages would reflect survival rates well as a factor predicting prognosis.
5) The cases of peritoneal dissemination were found more in younger patients than older ones. Age had nothing to do with liver metastasis. It was found more frequently in patients with serosal invasion, invaded by moderately differentiated adenocarcinoma and marked lymphtic and venous invasion.
6) There was a fall in the survival rate of patients undergoing curative resection almost according to age. Among them, significantly worse survival was found in patients aged 40-50 years, whose condition was mostly advanced on histological stage and Dukes classification.
7) Sufficient clearing of regional lymph node and considering of serosal invation for good prognosis from the surgical treatment are very important. For the future subject, to improve the surival rate, education about cancer. early detection and effect of multidisciplinary treatment are imperative.