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High Level Sacral Bone Resection for Locally Recurrent Rectal Cancer.
Nobuo Takiguchi1, Mamoru Uemura2, Masatoshi Kitakaze3
1Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Anticancer Research
|November 1, 2023
Summary
High sacrectomy is a feasible and safe surgical option for locally recurrent rectal cancer (LRRC) involving the upper sacrum. This procedure can achieve negative margins, offering a potential curative approach for selected patients.
Area of Science:
- Surgical Oncology
- Rectal Cancer Management
- Sacral Resection
Background:
- Locally recurrent rectal cancer (LRRC) with upper sacrum involvement is often a surgical contraindication.
- High sacrectomy for LRRC is controversial due to complexity and potential complications.
Purpose of the Study:
- To evaluate the feasibility, safety, and prognosis of high sacrectomy in patients with LRRC.
- To address the lack of comprehensive studies on this surgical approach.
Main Methods:
- Retrospective review of LRRC patients undergoing sacrectomy (excluding the inferior S2 margin) between 2003 and 2014.
- Analysis of resection margins, operative details, complications, and survival rates.
Main Results:
- Eight patients (median age 59) underwent high sacrectomy.
- Negative margins were achieved in 5/8 patients.
- Major complications included pelvic abscess (5/8), with no postoperative mortality.
Conclusions:
- High sacrectomy is a safe and feasible procedure for achieving negative margins in LRRC.
- The study suggests potential for improved local control and survival in carefully selected patients.
