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[Surgical therapy and prognosis of not curatively resectable rectum carcinoma. Results of a multicenter study of the Colorectal Carcinoma Study Group].

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.