title: [Pelvic exenteration for T4 rectal cancer: a series of 15 ressectable cases].
abstract: BACKGROUND
  Pelvic exenteration is the best therapeutic choice for treatment of T4 rectal cancer. Although, this operation still presents considerable mortality and high morbidity.
  
  
  OBJECTIVE
  To report on a series of 15 patients with a T4 rectal cancer at a general hospital and describe the outcomes (morbidity, mortality and long-term survival) following pelvic exenteration.
  
  
  METHODS
  Complete follow-up data were available on 15 patients who underwent pelvic exenteration for T4 rectal cancer between 1998 and 2006. These subjects comprised seven men and eight women with a mean age of 65 years. All of them presented serious incapacitating complaints. The surgical procedures included: infraelevator exenteration (n = 6), supraelevator exenteration (n = 4), posterior exenteration (n = 3) and, posterior exenteration plus partial cystectomy and ureterectomy (n = 2).
  
  
  RESULTS
  The mean duration of surgery was 403 minutes (280-485). The mean blood loss was 1620 mL (300-4.800). The postoperative mortality was 6,66% (n = 1). The overall rate morbidity was 53,3% (n = 8). The pathological examination showed that all resections were R0. Lymph node involvement was present in four patients (26,66 %), and all of them died due to tumor recurrence. The overall 5-year survival rate was 35,7%.
  
  
  CONCLUSIONS
  In spite of its aggressive nature and high morbidity, pelvic exenteration seems justified in rectal carcinoma when the disease extends to the urinary or genital tract. This procedure may offer long-term disease control.
authors.affiliation: Serviço de Cirurgia Geral, Oncocirurgia do Hospital do Servidor Publico Estadual de São Paulo, Francisco Morato de Oliveira, São Paulo, SP Brazil. sergiorenatopais@ig.com.br
authors.forename: Sergio Renato Pais
authors.initials: SR
authors.lastname: Costa
authors.forename: Ricardo César Pinto
authors.initials: RC
authors.lastname: Antunes
authors.forename: Raphael Paulo de
authors.initials: RP
authors.lastname: Paula
authors.forename: Miguel Angelo
authors.initials: MA
authors.lastname: Pedroso
authors.forename: José Francisco de Mattos
authors.initials: JF
authors.lastname: Farah
authors.forename: Renato Arioni
authors.initials: RA
authors.lastname: Lupinacci
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010385:Pelvic Exenteration / Q000009:adverse effects / Q000379:methods*; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome