title: Advanced rectal cancer in the female: reduction of pelvic recurrence by rectal resection en bloc with hysterectomy and/or posterior vaginal wall excision.
abstract: The authors report their experience with 20 female patients with advanced rectal cancer in whom rectal excision was combined with concomitant excision of the uterus and/or posterior vaginal wall. Six patients presented with a malignant fistula between the rectum and the genital tract; 10 had pre-operative radiotherapy, with a total dose of 50 Gy in seven patients and 30 Gy in three. The resection was judged as radical in 18 patients; the specimen was staged as a Dukes' B in eight and a Dukes' C in 10 cases. Three patients died within the follow-up period, due to intercurrent disease, without evidence of recurrence. Seven patients have been followed without evidence of disease for an average of 91 months (range 39-143 months). One patient is alive 5 years after surgery with a pelvic recurrence. Seven patients succumbed to distant metastases alone (n = 4) or to a combination of haematogenous metastases and pelvic recurrence (n = 3). The authors make a plea for local radicality in advanced rectal cancer in female patients, to preserve quality of life in most patients and a cure in some.
authors.affiliation: Department of Surgery, Groningen University Hospital, The Netherlands.
authors.forename: L M
authors.initials: LM
authors.lastname: Buhre
authors.forename: H J
authors.initials: HJ
authors.lastname: Mensink
authors.forename: J G
authors.initials: JG
authors.lastname: Aalders
authors.forename: D M
authors.initials: DM
authors.lastname: Mehta
authors.forename: R C
authors.initials: RC
authors.lastname: Verschueren
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D010386:Pelvic Neoplasms / Q000517:prevention & control*; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D014621:Vagina / Q000601:surgery*