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Total pelvic exenteration for locally advanced rectal carcinoma
1Department of Surgery, Cancer Hospital, Shanghai Medical University, China.
Diseases of the Colon and Rectum
|February 1, 1994
Summary
Total pelvic exenteration with lateral node dissection offers a 52% survival rate for advanced rectal cancer. Preoperative irradiation can help make fixed tumors resectable, improving outcomes for this challenging condition.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- Locally advanced rectal cancer often involves adjacent pelvic structures, posing significant treatment challenges.
- Standard treatments may be insufficient for tumors invading nearby organs or the sacrum.
Purpose of the Study:
- To evaluate the efficacy and outcomes of total pelvic exenteration combined with lateral node dissection for advanced rectal cancer.
- To assess the role of preoperative irradiation in improving resectability for fixed rectal tumors.
Main Methods:
- Total pelvic exenteration with lateral node dissection was performed on 31 patients with advanced rectal cancer.
- Preoperative irradiation was administered to nine patients with fixed tumors.
- Three patients with sacral involvement underwent exenteration with partial sacrectomy.
Main Results:
- The overall 5-year survival rate was 52%, with 56% for primary tumors.
- Three patients with sacral involvement died within 15 months due to local failure.
- Lateral node dissection was employed to increase the radicality of the surgical procedure.
Conclusions:
- Total pelvic exenteration with lateral node dissection is a viable option for locally advanced rectal cancer when tumors are not fixed to the pelvic wall.
- Preoperative irradiation can convert fixed rectal tumors into resectable ones, potentially improving surgical outcomes.