We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Determinants of survival following pelvic exenteration for primary rectal cancer.
- Authors
Radwan, R. W.; Jones, H. G.; Rawat, N.; Davies, M.; Evans, M. D.; Harris, D. A.; Beynon, J.; McGregor, A. D.; Morgan, A. R.; Freites, O.; Patel, B.; Askill, C.; Rowley, C.; Pudney, D.; Hatcher, O.; Bose, P.; Fenn, N.; Lucas, M. G.; Khot, U.; Chandrasekaran, T. V.
- Abstract
Background Pelvic exenteration is a potentially curative treatment for locally advanced primary rectal cancer. Previous studies have been limited by small sample sizes and heterogeneous data. A consecutive series of patients was studied to identify the clinicopathological determinants of survival. Methods All patients undergoing pelvic exenterative surgery for primary rectal cancer (1992-2014) at this hospital were analysed. The primary outcome measure was 5-year overall survival. Secondary endpoints included length of hospital stay, complication rate, 30-day mortality and disease recurrence rate. Statistical analysis was performed using Kaplan-Meier and Cox regression analysis. Results A total of 174 patients with a median age of 65 (range 31-90) years were included. Ninety-six patients underwent posterior pelvic exenteration and 78 had total pelvic exenteration. Median follow-up was 48 (range 1-229) months. Two patients (1·1 per cent) died within 30 days of surgery and 16·1 per cent returned to the operating theatre. The 5-year survival rate following complete resection ( R0) was 59·3 per cent. In univariable analysis, adverse survival was associated with advanced age ( P = 0·003), metastatic disease ( P = 0·001), pathological node status ( P = 0·001), circumferential resection margin ( P = 0·001), local recurrence ( P = 0·015) and the need for neoadjuvant therapy ( P = 0·039). Conclusion Pelvic exenteration is an aggressive treatment option with a high morbidity rate that provides favourable long-term outcomes in patients with locally advanced primary rectal cancer.
- Subjects
RECTAL cancer; ONCOLOGIC surgery; PELVIC exenteration; PELVIC surgery; DISEASE relapse; SURGERY
- Publication
British Journal of Surgery, 2015, Vol 102, Issue 10, p1278
- ISSN
0007-1323
- Publication type
Article
- DOI
10.1002/bjs.9841