Pelvic exenteration for recurrent and extensive primary colorectal adenocarcinoma

R. S. Yeung, Frederick L Moffat, R. E. Falk

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background. Local failure after curative surgery for colorectal adenocarcinoma remains a major source of morbidity and mortality. This retrospective analysis reviews the authors' experience with pelvic exenteration in the setting of recurrent and locally advanced colorectal cancer. Methods. Between 1979 and 1986, 50 pelvic exenterations were performed for recurrent (43) and primary (7) colorectal pelvic malignancies. Of these, 30 patients were operated on with curative intent, whereas 20 underwent operation for palliation of intractable pain, sepsis, fistula, bleeding, or bowel obstruction. Twenty-six patients had received radiation to 4000 cGy or more. Of the recurrent tumors, the median time from primary treatment to exenteration was 39.7 months. Results. Postoperative mortality included 7 in-hospital deaths (14%): 5 of 20 in the palliative group and 2 of 30 in the curative group. Complications were common (a total of 71 occurrences), but there has been a significant decrease with experience. The median survival was 19 months for the curative group and 10 months for the palliative group, excluding perioperative mortality. The 5-year survival was 6% overall, and 10% for the curative group. Eighty-nine percent of patients in the curative group had significant pain relief (71% complete, 18% partial), whereas 67% of those in the palliative group had complete or partial pain control. Conclusions. Long-term survival after pelvic exenteration for recurrent colorectal carcinoma is uncommon (2/43), but sustained palliation and local control can be achieved with acceptable morbidity and mortality in most patients with intractable pelvic symptoms.

Original languageEnglish
Pages (from-to)1853-1858
Number of pages6
JournalCancer
Volume72
Issue number6
StatePublished - Jan 1 1993

Fingerprint

Pelvic Exenteration
Adenocarcinoma
Mortality
Survival
Colorectal Neoplasms
Morbidity
Pain
Intractable Pain
Colorectal Surgery
Fistula
Neoplasms
Sepsis
Radiation
Hemorrhage

Keywords

  • colorectal carcinoma
  • exenteration
  • palliation
  • recurrence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pelvic exenteration for recurrent and extensive primary colorectal adenocarcinoma. / Yeung, R. S.; Moffat, Frederick L; Falk, R. E.

In: Cancer, Vol. 72, No. 6, 01.01.1993, p. 1853-1858.

Research output: Contribution to journalArticle

Yeung, R. S. ; Moffat, Frederick L ; Falk, R. E. / Pelvic exenteration for recurrent and extensive primary colorectal adenocarcinoma. In: Cancer. 1993 ; Vol. 72, No. 6. pp. 1853-1858.
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abstract = "Background. Local failure after curative surgery for colorectal adenocarcinoma remains a major source of morbidity and mortality. This retrospective analysis reviews the authors' experience with pelvic exenteration in the setting of recurrent and locally advanced colorectal cancer. Methods. Between 1979 and 1986, 50 pelvic exenterations were performed for recurrent (43) and primary (7) colorectal pelvic malignancies. Of these, 30 patients were operated on with curative intent, whereas 20 underwent operation for palliation of intractable pain, sepsis, fistula, bleeding, or bowel obstruction. Twenty-six patients had received radiation to 4000 cGy or more. Of the recurrent tumors, the median time from primary treatment to exenteration was 39.7 months. Results. Postoperative mortality included 7 in-hospital deaths (14{\%}): 5 of 20 in the palliative group and 2 of 30 in the curative group. Complications were common (a total of 71 occurrences), but there has been a significant decrease with experience. The median survival was 19 months for the curative group and 10 months for the palliative group, excluding perioperative mortality. The 5-year survival was 6{\%} overall, and 10{\%} for the curative group. Eighty-nine percent of patients in the curative group had significant pain relief (71{\%} complete, 18{\%} partial), whereas 67{\%} of those in the palliative group had complete or partial pain control. Conclusions. Long-term survival after pelvic exenteration for recurrent colorectal carcinoma is uncommon (2/43), but sustained palliation and local control can be achieved with acceptable morbidity and mortality in most patients with intractable pelvic symptoms.",
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N2 - Background. Local failure after curative surgery for colorectal adenocarcinoma remains a major source of morbidity and mortality. This retrospective analysis reviews the authors' experience with pelvic exenteration in the setting of recurrent and locally advanced colorectal cancer. Methods. Between 1979 and 1986, 50 pelvic exenterations were performed for recurrent (43) and primary (7) colorectal pelvic malignancies. Of these, 30 patients were operated on with curative intent, whereas 20 underwent operation for palliation of intractable pain, sepsis, fistula, bleeding, or bowel obstruction. Twenty-six patients had received radiation to 4000 cGy or more. Of the recurrent tumors, the median time from primary treatment to exenteration was 39.7 months. Results. Postoperative mortality included 7 in-hospital deaths (14%): 5 of 20 in the palliative group and 2 of 30 in the curative group. Complications were common (a total of 71 occurrences), but there has been a significant decrease with experience. The median survival was 19 months for the curative group and 10 months for the palliative group, excluding perioperative mortality. The 5-year survival was 6% overall, and 10% for the curative group. Eighty-nine percent of patients in the curative group had significant pain relief (71% complete, 18% partial), whereas 67% of those in the palliative group had complete or partial pain control. Conclusions. Long-term survival after pelvic exenteration for recurrent colorectal carcinoma is uncommon (2/43), but sustained palliation and local control can be achieved with acceptable morbidity and mortality in most patients with intractable pelvic symptoms.

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