Surgical treatment of locally advanced rectal cancer. Options and strategies.
OBJECTIVE
The results of surgical treatment of locally advanced rectal cancer with special regard to multivisceral resections and preoperative radiotherapy should be analyzed.


METHODS
From 10/86 until 12/95, 40 patients with preoperatively assessed T4 stage rectal cancer were treated in our department whose data were evaluated retrospectively.


RESULTS
Apart from 10 nonresecting procedures we performed 30 resections in which the mortality rate was 7%. In 50% of these patients a multivisceral resection was conducted. A R0 situation could be achieved in 70%. But only in 53% the operation was carried out with curative approach due to distant metastasis. After extended resections more frequent urological complications resulted in prolonged hospitalization. Survival time was markedly longer in patients without tumor residuals or metastasis. Following preoperative radiotherapy a higher number in tumor free patients and better prognosis was noticed.


CONCLUSIONS
In accordance to the literature it is suggested to submit patients with T4-stage rectal cancer to preoperative radiation to improve the overall outcome.
Aleksic
M
M
Department of Surgery, Gerresheim Hospital, Düsseldorf, Germany.
Hennes
N
N
Ulrich
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003082:Colectomy / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome