Surgical results of total pelvic exenteration for locally advanced colorectal adenocarcinoma.

BACKGROUND/AIMS: Although total pelvic exenteration (TPE) may lead to local tumor control and improved quality of life in patients with locally advanced colorectal cancer, an adequate understanding of prognostic factors, indications and potential complications associated with these procedures is needed.

METHODOLOGY

Records for 15 patients, who underwent TPE for colorectal adenocarcinoma at Oita Prefectural Hospital between January 1983 and November 2001, were reviewed, retrospectively.

RESULTS

Ten (66.7%) had positive lymphatic involvement, seven (46.7%) had positive vascular involvement, and three (20%) had positive lymph node metastases. Bladder involvement histologically was evident in eight patients (53.3%). With regard to diagnostic assessment of bladder involvement using CT, the sensitivity and specificity were 83.3% and 60%, respectively. Six of 15 patients (40%) developed complications. Overall local recurrence was observed in 6 (40%) of the 15. The cumulative overall 5-year survival rate of the 15 patients in this study was 54.7%. In the univariate analysis, vascular involvement significantly influenced survival.

CONCLUSIONS

TPE appears to be relatively safe and effective for treatment of locally advanced colorectal adenocarcinoma. Vascular involvement was recognized as the only reliable prognostic clinicopathological characteristic.