Choosing the correct surgeon for colorectal cancer surgical treatment is very important. What are the most important factors in colorectal cancer surgery? How to perform modern surgical operation to remove colon cancer or rectal cancer tumor? Leading Swiss abdominal cancer surgeon explains surgical treatment options for colorectal cancer and liver tumors.
Colon cancer surgery best center. 1. Dr. Anton Titov, MD. Let's start the conversation with colon cancer. Colorectal cancer surgery remains the first and foremost treatment method for colon cancer. And you published reviews on optimal selection of colorectal cancer surgery methods to improve colon cancer patients' survival. Colorectal cancer surgeon during surgical operation often corrects staging decisions done preoperatively. Surgeon makes intraoperative observations and adjusts colon cancer staging. How do surgery options depend on the location and extent of the colon cancer tumor? How does surgeon help in overall colon cancer treatment decisions? Dr. Christoph Maurer, MD. Yes, this is a very important issue. First, colon cancer surgery method is highly dependent on the location of the primary Some colon cancer tumors are located in the splenic or hepatic flexure. This is where large bowel makes a turn. These cancers have a bi-directional or three-directional lymph node spread. So, we must be aware of this circumstance. And we have to include these lymphatic nodes and lymphatic vessels into our tumor resection margins. Sometimes, a primary colorectal tumor is adherent to neighboring organs. These tumors should never be separated from the neighboring organ. Because this organ may be infiltrated by a tumor. If we first separate the tumor from the neighboring organ, then we risk to open the tumor. This can spill cancer tumor cells and cause cancer seeding. And tumor seeding and tumor spillage during surgical operation reduces the five-year survival expectancy by about 30%. So, we have to do a so-called en bloc colon cancer tumor resection. Never separate neighboring organs that adhere to colon cancer tumor. We have to do an en bloc resection of colon cancer, including parts of the neighboring organ. So we do a complete resection en bloc. Dr. Anton Titov, MD. And how much of the normal colon do you usually take out? Do you have healthy colon margins just outside of the tumor? Dr. Christoph Maurer, MD. It's important to have at least 10 centimeters of normal colon on both sides of the primary colon cancer tumor. Colon cancer tumor in the rectosigmoid junction is the exception. Then we have only five centimeters, this little resection margin. But otherwise, we need absolutely at least 10 centimeters of normal-looking colon when we remove colon cancer tumor during surgery. Because along the tumor margin of arteries we have the potential risk to have lymph node metastasis from colon cancer. So if we take a too short segment of the colon. Then we risk to leave behind lymph node metastases in the local regional area of colon cancer tumor.