Carcinoma of the stomach, colon, rectum and the biliary ducts is a challenging problem. This challenge is greatly multiplied whenever the carcinoma leaves the site of its origin and invades a neighboring organ or organs. When such a situation is encountered at laparotomy, the surgeon must evaluate resectability against (1) technical limitations, (2) risk to the patient, and (3) the estimated physical and physiological defect to be inflicted by the proposed operation.
Early diagnosis followed by proper treatment has been constantly emphasized as the best existing weapon against cancer. The logic of the statement and the desirability of such an attitude are obvious and unchallenged. However, the condition of early diagnosis of cancer cannot always be obtained. Many patients, for various reasons, report for definitive treatment only when the disease has spread beyond the perimeter of the original site of the neoplasm.
The need to care for these patients is