[Pelvic exenteration for T4 rectal cancer: a series of 15 ressectable cases].
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.
Costa
Sergio Renato Pais
SR
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
Antunes
Ricardo César Pinto
RC
Paula
Raphael Paulo de
RP
Pedroso
Miguel Angelo
MA
Farah
José Francisco de Mattos
JF
Lupinacci
Renato Arioni
RA
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