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Related Experiment Videos

Radical surgery for extensive rectal cancer: is it worthwhile?

F L Moffat1, R E Falk

  • 1Department of Surgery, University of Miami School of Medicine, Sylvester Comprehensive Cancer Center, FL 33136, USA.

Recent Results in Cancer Research. Fortschritte Der Krebsforschung. Progres Dans Les Recherches Sur Le Cancer
|July 22, 1998
PubMed
Summary

Pelvic exenteration (PE) offers a chance for cure in select rectal cancer patients but involves significant risks. Careful patient selection and counseling are crucial for informed consent and optimal outcomes.

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Area of Science:

  • Surgical Oncology
  • Rectal Cancer Treatment
  • Radical Surgical Procedures

Background:

  • Rectal cancer can remain confined to the pelvis, causing severe quality-of-life issues.
  • Symptoms are often refractory to non-surgical treatments, necessitating aggressive intervention.
  • Complete tumor removal with clear margins is essential for cure.

Purpose of the Study:

  • To define the role and outcomes of pelvic exenteration (PE) for advanced rectal cancer.
  • To identify patient selection criteria and contraindications for PE.
  • To evaluate the impact of PE on survival and quality of life.

Main Methods:

  • Review of surgical principles and outcomes for pelvic exenteration in rectal cancer.
  • Identification of factors influencing resectability and surgical success.

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  • Analysis of survival data and symptom palliation in selected patients.

    • Main Results:

    • Pelvic exenteration (PE) is the most radical surgery for rectal cancer, offering >40% 5-year survival for primary advanced disease.
    • Contraindications include pelvic sidewall fixation, lumbosacral spine/plexus invasion, and iliac vessel encasement.
    • PE can palliate disabling symptoms in carefully selected incurable patients, improving quality of life.

    Conclusions:

    • Pelvic exenteration (PE) is a high-risk, radical procedure for advanced rectal cancer with potential for cure or palliation.
    • Meticulous patient selection, preoperative counseling, and exclusion of extrapelvic disease are critical.
    • While challenging, PE can provide significant benefits for carefully chosen patients with limited or recurrent rectal cancer.