title: Total pelvic exenteration for rectal cancer: outcomes and prognostic factors.
abstract: BACKGROUND
  To perform complete resection of locally advanced and recurrent rectal carcinoma, total pelvic exenteration (TPE) may be attempted. We identified disease-related outcomes and prognostic factors.
  
  
  METHODS
  We conducted a single-centre review of patients who underwent TPE for rectal carcinoma over a 10-year period.
  
  
  RESULTS
  We included 28 patients in our study. After a median follow-up of 35 months, 53.6% of patients were alive with no evidence of disease. The 3-year actuarial disease-free and overall survival rates were 52.2% and 75.1%, respectively. On univariate analysis, recurrent disease, preoperative body mass index greater than 30 and lymphatic invasion were poor prognostic factors for disease-free survival, and only lymphatic invasion predicted overall survival. Additionally, multivariate analysis identified lymphatic invasion as an independent poor prognostic factor for disease-free survival in this patient population with locally advanced and recurrent rectal carcinoma.
  
  
  CONCLUSIONS
  Despite the significant morbidity, TPE can provide long-term survival in patients with rectal carcinoma. Additionally, lymphatic invasion on final pathology was an independent prognostic factor for disease-free survival.
authors.affiliation: Division of Urology, Department of Medicine, Schulich School of Medicine, University of Western Ontario, London, Ontario.
authors.forename: Trustin S
authors.initials: TS
authors.lastname: Domes
authors.forename: Patrick H D
authors.initials: PH
authors.lastname: Colquhoun
authors.forename: Brian
authors.initials: B
authors.lastname: Taylor
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Izawa
authors.forename: Andrew A
authors.initials: AA
authors.lastname: House
authors.forename: Patrick P W
authors.initials: PP
authors.lastname: Luke
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Izawa
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010385:Pelvic Exenteration; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome