Total Pelvic Exenteration with Distal Sacrectomy for Fixed Recurrent Rectal Cancer

Moriya, Yoshihiro; Aoki, Takayuki; Fujita, Shin; Yamamoto, Seiichirou

doi:10.1016/j.soc.2004.11.014

Cited by 34 publications

(31 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is well known that local recurrence is the most important prognostic factor for rectal carcinoma [29][30][31] . It was reported that local recurrence can be found in 4%-50% of patients with rectal carcinoma after curative resection, and lateral lymph node metastasis may be the important factor for local recurrence [15,16] .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of lateral lymph node metastasis for advanced low rectal cancer

Wu¹,

Wan²,

Li³

et al. 2007

WJG

View full text Add to dashboard Cite

AIM:To evaluate the risk factors for lateral lymph node metastasis in patients with advanced low rectal cancer, in order to make the effective selection of patients who could benefit from lateral lymph node dissection, as well as the relationship of lateral lymph node metastasis with local recurrence and survival of patients with advanced low rectal cancer. METHOD S :A t o t a l o f 9 6 c o n s e c u t i v e p a t i e n t s who underwent curative surgery with lateral pelvic lymphadenectomy for advanced lower rectal cancer were retrospectively analyzed. The relation of lateral lymph node metastasis with clinicopathologic characteristics, local recurrence and survival of patients was identified. RESULTS:Lateral lymph node metastasis was observed in 14.6% (14/96) of patients with advanced low rectal cancer. Lateral lymph node metastasis was detected in 10 (25.0%) of 40 patients with tumor diameter ≥ 5 cm and in 4 (7.1%) of 56 patients with tumor diameter < 5 cm. The difference between the two groups was statistically significant (χ 2 = 5.973, P = 0.015). Lateral lymph node metastasis was more frequent in patients with 4/4 diameter of tumor infiltration (7 of 10 cases, 70.0%), compared with patients with 3/4, 2/4 and 1/4 diameter of tumor infiltration (3 of 25 cases, 12.0%; 3 of 45 cases, 6.7%; 1 of 16 cases, 6.3%) (χ 2 = 27.944, P = 0.0001).The lateral lymph node metastasis rate was 30.0% (9 of 30 cases), 9.1% (4 of 44 cases) and 4.5% (1 of 22 cases) for poorly, moderately and well-differentiated carcinoma, respectively. The difference between the three groups was statistically significant (χ 2 = 8.569, P = 0.014). Local recurrence was 18.8% (18 of 96 cases), 64.3% (9 of 14 cases), and 11.0% (9 of 82 cases) in patients with advanced low rectal cancer, in those with and without lateral lymph node metastasis, respectively. The difference between the two groups was statistically significant (χ 2 = 22.308, P = 0.0001).Kaplan-Meier survival analysis showed significant improvements in median survival (80.9 ± 2.1 m, 95%CI: 76.7-85.1 m vs 38 ± 6.7 m, 95% CI: 24.8-51.2 m) of patients without lateral lymph node metastasis compared with those with lateral lymph node metastasis (log-rank, P = 0.0001). CONCLUSION:Tumor diameter, infiltration and differentiation are significant risk factors for lateral lymph node metastasis. Lateral pelvic lymphadenectomy should be performed following surgery for patients with tumor diameter ≥ 5 cm. Lateral lymph node metastasis is an important predictor for local recurrence and survival in patients with advanced low rectal cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic value of lateral lymph node metastasis for advanced low rectal cancer

Wu¹,

Wan²,

Li³

et al. 2007

WJG

View full text Add to dashboard Cite

show abstract

“…Total pelvic exenteration with distal sacrectomy (TPES), originally described by Wanebo and Marcove 3 , consists of extended surgical resection of the recurrent tumour and affected neighbouring organs, including the bladder, prostate, uterus, vagina, pelvic wall and sacrum, along with urinary tract reconstruction using an ileal conduit. In a previous study 4,5 , the present authors found that TPES with complete (R0) resection achieved a 5-year relapse-free survival rate of 49 per cent in patients with local relapse fixed in the pelvis.…”

Section: Introductionmentioning

confidence: 51%

“…The surgical technique for TPES has been described in detail previously 4,5 including the maximum diameter of the tumour was cut, embedded in paraffin, and stained with haematoxylin and eosin. Microscopic examination determined the histological type according to the Japanese classification of colorectal carcinoma 6 , invasion to surrounding organs, perineural, venous and lymphatic invasion, fibrous tissue and abscess formation around the recurrent tumour.…”

Section: Methodsmentioning

confidence: 99%

Clinicopathological significance of fibrous tissue around fixed recurrent rectal cancer in the pelvis

Uehara

Shimoda

Nakanishi

et al. 2007

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…It is well known that local recurrence is of rectal carcinoma plays an important role in its prognosis [1][2][3] . However, local recurrence of rectal carcinoma occurs in about 4%-50% of patients even after radical resection of primary tumors and lymph nodes [4][5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for local recurrence of middle and lower rectal carcinoma after curative resection

Wan²,

Zhao³

et al. 2008

WJG

View full text Add to dashboard Cite

AIM:To explore the risk factors for local recurrence of middle and lower rectal carcinoma after curative resection. METHODS: Specimens of middle and lower rectal carcinoma from 56 patients who received curative resection at the Department of General Surgery of Guangdong Provincial People's Hospital were studied. A large slice technique was used to detect mesorectal metastasis and evaluate circumferential resection margin status. The relations between clinicopathologic c h a r a c t e r i s t i c s , m e s o r e c t a l m e t a s t a s i s a n d circumferential resection margin status were identified in patients with local recurrence of middle and lower rectal carcinoma. RESULTS: Local recurrence of middle and lower rectal carcinoma after curative resection occurred in 7 of the 56 patients (12.5%), and was significantly associated with family history (c

show abstract

Total Pelvic Exenteration with Distal Sacrectomy for Fixed Recurrent Rectal Cancer

Cited by 34 publications

References 35 publications

Prognostic value of lateral lymph node metastasis for advanced low rectal cancer

Prognostic value of lateral lymph node metastasis for advanced low rectal cancer

Clinicopathological significance of fibrous tissue around fixed recurrent rectal cancer in the pelvis

Risk factors for local recurrence of middle and lower rectal carcinoma after curative resection

Contact Info

Product

Resources

About