Total pelvic exenteration for locally advanced colorectal carcinoma

✍ Scribed by Dr. K. Shtrouzu; H. Isomoto; T. Kakegawa

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 412 KB
• Volume: 83
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800830109

✦ Synopsis

Twenty-six patients who underwent total pelvic exenteration for locally advanced colorectal cancer were studied retrospectively. The operative mortality rate was 8 per cent (two deaths). In patients with stage IT primary disease the recurrence rate after curative surgery was three of seven, although the mean survival time was 58 months and the 5-year survival rate 71 per cent. Patients with stage 111 primary disease had a shorter mean survival time regardless of supposed curability (curative 14 months versus non-curative 9 months). Patients with stage IV disease had a mean survival time of 5 months. In patients who underwent curative surgery for recurrent disease the mean survival time was 33 months and 5-year survival rate 25 per cent, although in those receiving non-curative surgery the survival time was significantly shorter at 10 months (P < 0.05). Total pelvic exenteration is warranted for patients with stage I1 locally advanced colorectal carcinoma and is an option for those with recurrent carcinoma when performed with curvative intent.

Total pelvic exenteration for advanced colorectal carcinoma localized to the pelvic region remains a formidable, albeit potentially curative, procedure. Complete removal of involved adjacent organs such as the vagina, uterus, bladder and prostate gland can be effective in controlling local disease and improving palliation. However, complications are more severe than following standard resection for colorectal carcinoma'-6. The 5-year survival rate after radical pelvic exenteration varies from 32 to 79 per cent'-' and the prognosis in selected patients can be excellent. This study was designed to review total pelvic exenteration performed for locally advanced colorectal carcinoma.