Patterns of Recurrence After Pelvic Exenteration for Colorectal Adenocarcinoma

Abstract

We performed a retrospective review of 68 patients who underwent pelvic exenteration for colorectal adenocarcinoma. Forty-seven patients had surgery for primary disease and 21 for recurrence. Clinical recurrence developed in 30 (44%) of 68 patients overall. Of these, 17 (57%) developed locoregional disease only as their first recurrence. This included nine (56%) of 16 patients with primary disease and eight (57%) of 14 patients with recurrent disease. Clinical recurrence developed in 16 (34%) of 47 patients with primary disease and 14 (66%) of 21 patients with recurrent disease. The overall 5-year survival rates were 43% and 20%, respectively. We conclude that locoregional recurrence remains a significant problem for primary or recurrent colorectal carcinoma even after radical pelvic surgery.

Exenterative pelvic surgery

“…The long-term results of radical pelvic surgery for recurrent disease are substantially poorer than for patients who have not had previous operations. In the series of Hafner et al [53], for example, the recurrence rate was 34% in patients with primary disease and 66% in patients having surgery for recurrent rectal carcinoma. The overall 5-year survival rate was 43% in patients with primary tumors compared with 20% in those with recurrent lesions.…”

“…Table VI presents 5 series totaling 205 patients subjected to pelvic exenteration for rectal cancer [14,41,49,53]. In 177 patients (86%), the operation was the primary form of treatment.…”

“…In these series, the 5-year survival rate ranged from 31% to 56%, averaging 44% at 5 years. The most common sites of recurrences are the pelvis, perineum, lung, and liver [47,53].…”

Pelvic exenterative procedures for locally advanced or recurrent colorectal carcinoma in a community hospital

“…Published series originate mainly from large academic institutions in the United States [11,12]. Herein, we report our experience with pelvic exenterations for colorectal cancers in a small community hospital.…”

Exenteração pélvica e preservação dos esfíncteres: análise de 96 casos

“…A apresentação inicial dos pacientes também foi descrita como fator prognóstico (Hafner et al 1991;Jimenez et al, 2003).…”