Total pelvic exenteration for primary locally advanced and locally recurrent rectal cancer

M. Vermaas, F. T. J. Ferenschild, C. Verhoef, J. J. M. E. Nuyttens, A. W. K. S. Marinelli, T. Wiggers, W. J. Kirkels, A. M. M. Eggermont, J. H. W. de Wilt*

*Corresponding author for this work

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    93 Citations (Scopus)

    Abstract

    Aims: To report the role of total pelvic exenteration in a series of locally advanced and recurrent rectal cancers.

    Methods: In the period 1994-2004, TPE was performed in 35 of 296 patients with primary locally advanced and recurrent rectal cancer treated in the Daniel den Hoed Cancer Center; 23 of 176 with primary locally advanced and 12 of 120 with recurrent rectal cancer. All but one patient received pre-operative External Beam Radiation Therapy (EBRT). After 1997, Intra Operative Radiotherapy (IORT) was performed in case of a resection margin less than 2 mm.

    Results: Overall major complication rates were not significantly different between patients with primary and recurrent rectal cancer (26% vs. 50%, p = 0.94). The hospital mortality rate was 3%. The 5-year local control and overall survival of patients with primary locally advanced rectal cancer were 88% and 52%, respectively. In patients with recurrent rectal cancer 3-year local control and survival rates were 60% and 32%, respectively. An incomplete resection, preoperative pain and advanced Wanebo stage for recurrent cancer were negative prognostic factors for both local control and overall survival.

    Conclusion: TPE in primary locally advanced rectal cancer enables good local control and acceptable overall survival, thereby justifying the use of the procedure. Patients with recurrent rectal cancer showed a high rate of major complications, a high distant metastasis rate, and a poor overall survival. (c) 2006 Elsevier Ltd. All rights reserved.

    Original languageEnglish
    Pages (from-to)452-458
    Number of pages7
    JournalEuropean Journal of Surgical Oncology
    Volume33
    Issue number4
    DOIs
    Publication statusPublished - May-2007

    Keywords

    • pelvic
    • exenteration
    • locally advanced
    • rectal
    • cancer
    • TOTAL MESORECTAL EXCISION
    • INTRAOPERATIVE RADIOTHERAPY
    • COLORECTAL-CANCER
    • SHORT-TERM
    • RESECTION
    • IRRADIATION
    • SURGERY
    • CHEMORADIOTHERAPY
    • COMPLICATIONS
    • EXPERIENCE

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