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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Multivisceral resection for primary locally advanced rectal carcinoma
D A Harris1, M Davies, M G Lucas
1Abertawe Bro Morgannwg University Local Health Board, Swansea, UK. dean.harris2@wales.nhs.uk
The British Journal of Surgery
|June 10, 2011
Summary
Aggressive surgery for advanced rectal cancer (T4a) can lead to long-term survival. Complete resection is key, as local recurrence often indicates systemic disease, not surgical margins.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Pelvic multivisceral resection is a curative option for locally advanced rectal cancer.
- Clinical T4 primary rectal cancer presents unique treatment challenges.
Purpose of the Study:
- To assess clinical outcomes of multivisceral resection for T4 rectal cancer.
- To identify determinants of survival and local recurrence in these patients.
Main Methods:
- A single-center cohort study of 42 patients undergoing multivisceral resection (2000-2009).
- Kaplan-Meier survival curves and Cox regression analysis were used.
- Median follow-up was 30 months.
Main Results:
- Complete resection was achieved in 39 of 42 patients with negative margins.
- The 5-year overall survival rate for complete resections was 48%.
- Local recurrence was significantly predicted by metastatic and nodal disease, not resection margins.
Conclusions:
- Complete resection via aggressive surgical strategy predicts long-term survival in selected T4a rectal cancer patients.
- Local recurrence in this context is indicative of systemic disease progression.
