RECURRENCE IN CARCINOMA OF THE COLON AND PROXIMAL RECTUM FOLLOWING RESECTION FOR CARCINOMA

Abstract

ALL SURGEONS are aware of the relatively high incidence of local recurrence L at the suture line in primary resection and end-to-end anastomosis for carcinoma of the colon and proximal rectum. I am of the opinion that at least half of the recurrences at the suture line are local implants and I have previously called attention to this possibility.¹ It is obvious that there is enough manipulation of the tumor during the resection to result in desquamation of numerous cancer cells from the primary lesion. Moreover, we now know with the aid of the Papanicolaou stain that cancer cells desquamate profusely from ulcerating tumors. Although it is unlikely that these desquamated cells would become implanted on normal mucosa, it may be assumed that they might become implanted on open wounds or ulcerated areas and grow. There is ample evidence that cancer cells can be implanted in breast wounds during