THE DEVELOPMENT of modern concepts in the surgical treatment of cancer of the colon and rectum is one of the brighter pages in the annals of surgery. Progressive improvement in supportive measures and surgical skills during the past 30 years have increased materially the operability and resectability of colorectal cancers, while the operative mortality has declined.1,2 Although substantial improvement in salvage rates is reflected in current reports from the literature, the sobering fact remains that more than half of the patients who acquire cancer of the large bowel will die from their disease. Furthermore, data from the End Results Group of the Biometry Branch, National Institutes of Health, suggest that there has been essentially no change in the relative five-year survival rates for patients with colorectal cancer during the past 20 years.3
Special Problems Affecting Surgical Management
Environomental factors have been implicated in the etiology of large-bowel cancer.