When a colorectal cancer has grown through the wall of the colon or rectum and into other adjacent tissues or organs, it is identified as a T4 primary tumor. If there is no evidence of distant metastasis then it is labeled a locally advanced tumor. Such locally advanced tumors account for approximately 5-15 % of new colorectal cancers. Surgery remains the principal treatment modality for patients with locally advanced colorectal cancer. Studies have demonstrated planned en bloc or multivisceral resections rather than intraoperative assessment of margins more likely results in R0 resections leading to better local control and long-term survival. However, the decision-making for a surgeon confronting a T4 colorectal cancer is challenging because surgery related mortality rates after multivisceral resections are reported up to 12%.

Fundamental to oncological surgery are balancing of the risks of postoperative complications with survival benefit gained with the operation. There are limited multi-institutional study describing the perioperative complication rates and long-term survival of patients undergoing multivisceral resections of T4 colon cancer and T4 rectal cancers. It is also unclear what happens to patients who receive neoadjuvant chemotherapy and radiation to avoid multivisceral resections and their long-term prognosis.

Our objective then is to evaluate the safety and long-term survival of patients with T4 colon cancer, T4 rectosigmoid cancers, and T4 rectal cancers following multivisceral resections using a multi-institutional national cancer database.

One selected candidate will receive a stipend via the DSI Scholars program. Amount is subject to available funding.

Faculty Advisor

  • Professor Sung Kwon
  • Department/School: Colorectal Surgery/CUMC
  • Location: CUMC
  • The goals of the Center for Innovation and Outcomes Research (CIOR) are to streamline data acquisition and management, conduct research related to surgical outcomes and quality.

Project timeline

  • Earliest starting date: 03/01/2019
  • End date: 07/30/2019
  • Number of hours per week of research expected during Spring 2019: ~5
  • Number of hours per week of research expected during Summer 2019: ~5

Candidate requirements

  • Skill sets: Data cleaning/preparation, statistical analysis
  • Student eligibility (as of Spring 2019): freshman, sophomore, junior, senior, master’s
  • International students on F1 or J1 visa: eligible