Lower GI 2016

The Royal Marsden

Vascular Invasion

• Brown and Warren Surg Obstet Gynaecol1938 • 170 rectal cancer post mortem examinations majority palliative colostomy/ no surgery/ immediate postoperative death. • histological evidence of tumour invasion of veins in 61% of 165 rectal adenocarcinomas • 67 of the 100 patients with venous invasion were found to have visceral metastases, mostly liver. • Only one case of metastasis in the absence of any vascular invasion was found