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. 2015 Sep;89(3):131-7.
doi: 10.4174/astr.2015.89.3.131. Epub 2015 Aug 24.

Outcomes of pelvic exenteration for recurrent or primary locally advanced colorectal cancer

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Outcomes of pelvic exenteration for recurrent or primary locally advanced colorectal cancer

Hwa Yeon Yang et al. Ann Surg Treat Res. 2015 Sep.

Abstract

Purpose: The objective of this study was to assess the clinical outcomes of pelvic exenteration for patients with primary locally advanced colorectal cancer (LACRC) or locally recurrent colorectal cancer (LRCRC), and to identify clinically relevant prognostic factors.

Methods: Between January 2001 and December 2010, 40 consecutive patients with primary LACRC or LRCRC underwent pelvic exenteration at the National Cancer Center, Republic of Korea. We retrospectively reviewed their medical records.

Results: The median age was 59 years and the median follow-up time was 26 months (range, 1-117 months). The overall complication and in-hospital mortality rates were 70% (28/40) and 7.5% (3/40), respectively. The complication rates were similar between patients with primary LACRC (69.6%) and those with LRCRC (70.6%). The overall recurrence rate was 50% (17/34), and was lower in patients with primary LACRC than in patients with LRCRC (33.3% vs. 76.9%, P = 0.032). The 5-year overall survival was significantly different between primary LACRC and patients with LRCRC (58.7% vs. 11.8%, P = 0.022). Multivariate analysis revealed that radicality (R0 vs. R1/R2) was an independent prognostic factor for overall survival (P = 0.020).

Conclusion: The complication and operative mortality rates of pelvic exenteration remained high, but pelvic exenteration might provide an opportunity for long-term survival and good local control. Complete (R0) resection was the only independent prognostic factor for overall survival.

Keywords: Colorectal neoplasms; Local neoplasm recurrences; Pelvic exenteration.

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Conflict of interest statement

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Kapla-Meier analysis of overall survival after pelvic exenteration in patients with primary advanced or recurrent colorectal cancer.
Fig. 2
Fig. 2. Comparison of overall survival after pelvic exenteration between patients with primary locally advanced colorectal carcinoma and patients with locally recurrent colorectal cancer (Kaplan-Meier analysis; log-rank test, P = 0.022).
Fig. 3
Fig. 3. Comparison of overall survival after complete (R0) and incomplete (R1 : R2) total pelvic exenteration (Kaplan-Meier analysis; log-rank test, P = 0.015).

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