Fighting Beyond the Colon: Early Surgical Outcomes of Urinary System Involvement in Locally Advanced Colorectal Cancer

INTRODUCTION: Locally advanced colorectal cancers (LACRCs) frequently invade adjacent organs, most commonly the urinary bladder and ureters, requiring multivisceral en bloc resections. Genitourinary involvement complicates the surgical approach and often necessitates collaboration with multiple surgical disciplines. This study evaluates the clinical characteristics and early postoperative outcomes of patients undergoing surgery for LACRC with urinary system invasion by a single surgical oncology team.
METHODS: This retrospective study included 23 patients who underwent en bloc resection for LACRC with concurrent urinary system involvement at......between January 2023 and January 2025. Surgical procedures included partial cystectomy, ureteral resection, and ureteroneocystostomy. Clinical, demographic, and pathological data were collected, and postoperative complications were analyzed.
RESULTS: Of the 23 patients, 65.2% were female, with a mean age of 65.2 ± 7.2 years. The most common procedure was ureteroneocystostomy (56.5%). Open surgery was performed in 56.5% of cases, and 52.2% received neoadjuvant therapy. R0 resection was achieved in 95.7% of patients. Postoperative complications included wound infections (65.2%), ileus (43.5%), and urinary infections (17.4%). Urinary anastomotic leakage occurred in one patient. No reoperations were required, and 1-year mortality was 4.3%.
DISCUSSION AND CONCLUSION: En bloc resection of LACRC with genitourinary invasion can be safely and effectively performed by a dedicated surgical oncology team, achieving high R0 resection rates and acceptable complication rates. These findings highlight the feasibility of single-team management in specialized centers. However, larger multicenter studies are warranted to confirm long-term outcomes and improve patient selection and perioperative care.

Keywords: Locally advanced colorectal cancer, Bladder resection, Urinary resection