Patterns of recurrence following pelvic exenteration and external radiotherapy for locally advanced primary rectal adenocarcinoma.

Abstract

BACKGROUND:

Local recurrence remains the main site of failure after pelvic exenteration for locally advanced primary rectal adenocarcinoma. This is a report on the patterns of recurrence in a group of such patients treated with pelvic exenteration and radiotherapy.

METHODS:

Between 1980 and 1992, we treated 49 patients. Thirty-one received preoperative radiotherapy (pre-RT), 4,500 cGy. Six weeks later, we performed posterior pelvic exenteration (PPE) in 21 patients, and total pelvic exenteration (TPE) in 10. Nine patients received postoperative radiotherapy (post-RT), 5,000 cGy after a PPE. Nine patients had surgery only, PPE (n = 7) and TPE (n = 2).

RESULTS:

Surgical mortality occurred in 16% of those patients who received pre-RT. The median follow-up was 52 months. Recurrences occurred in 23% of those patients who received pre-RT (local, one; local/distant, one; distant, four); in 88% of those patients treated with surgery only (local/distant, four; distant, four); and in 11% of those treated with post-RT (distant, one). The 5-year survival for patients who received radiotherapy was 66 versus 44% for those treated with surgery only.

CONCLUSION:

Local control of locally advanced primary rectal adenocarcinoma requiring a pelvic exenteration is improved by the addition of radiotherapy. When recurrences do occur they are predominantly at extrapelvic sites.

• Authors: P Luna-Perez, S Delgado, S Labastida, N Ortiz, D Rodriguez, L Herrera
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 3 Issue 6 Pg. 526-33 (Nov 1996) ISSN: 1068-9265 [Print] United States
• PMID: 8915483 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adenocarcinoma (pathology, radiotherapy, surgery)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Pelvic Exenteration
• Postoperative Complications
• Rectal Neoplasms (pathology, radiotherapy, surgery)