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Exenterative surgery for locally advanced rectosigmoid cancers. Is it worthwhile?

M J Lopez1, W G Kraybill, R S Downey

  • 1Department of Surgery, Ellis Fischel State Cancer Center, Columbia, MO 65203.

Surgery
|October 1, 1987
PubMed
Summary
This summary is machine-generated.

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Total pelvic exenteration for rectosigmoid cancer offers a survival rate exceeding 40% at 5 years. This procedure, while having risks, shows decreasing mortality and acceptable morbidity in selected patients.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Rectosigmoid cancers present significant treatment challenges, particularly when locally advanced.
  • Total pelvic exenteration (TPE) is a radical surgical option for select cases.

Purpose of the Study:

  • To evaluate the outcomes of total pelvic exenteration for rectosigmoid cancer.
  • To assess the morbidity, mortality, and survival rates associated with TPE.

Main Methods:

  • Retrospective analysis of 24 patients who underwent TPE for rectosigmoid cancer over 30 years.
  • Review of clinicopathologic data, including staging (Dukes' B/C), prior treatments, operative outcomes, and survival.

Main Results:

  • Operative mortality decreased over time (20.8% overall to 9% in the last decade).

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  • Morbidity rate was 26.3%, with prior treatment being a predictor of complications.
  • Overall 5-year survival was 41.6%, with higher recurrence rates in Dukes' C (57%) versus Dukes' B (27%) lesions.

    • Conclusions:

    • Total pelvic exenteration is a viable option for selected, primary, locally advanced rectosigmoid cancers in good-risk patients.
    • The procedure can be performed with acceptable morbidity and mortality, offering a >40% 5-year survival.
    • Prior treatment significantly impacts morbidity; age and nodal status may influence outcomes but require further study.