title: Surgical treatment of extraluminal pelvic recurrence from rectal cancer: oncological management and resection techniques.
abstract: Local recurrence (LR) after curative surgery for rectal cancer occurs in 4 to 33% of cases especially with suboptimal surgery (non-TME). For numerous patients, diagnosis of LR is done at late stage of the disease because of the high rate of asymptomatic patients. MRI and PET-scan are the most performing exams to assess the local and general extension, with high diagnostic accuracy (sensibility 85% and specificity 92%). For extraluminal pelvic recurrences from rectal cancer, pelvic exenterations alone or with irradiation (preoperative and/or intraoperative) can afford a R0 resection rate ranging from 30% to 45% with acceptable morbidity. Morbidity and mortality rates are high for total exenteration and abdominosacral resection. After curative surgery, 5-year global survival from 30% to 40% is observed. Careful selection of patients with better preoperative status before resection is needed to achieve more curative resections and increase long-term survivor rates.
authors.affiliation: Department of Digestive Surgery, Purpan University Hospital, 1, place Baylac, 31000 Toulouse, France. pereira31000@gmail.com
authors.forename: P
authors.initials: P
authors.lastname: Pereira
authors.forename: L
authors.initials: L
authors.lastname: Ghouti
authors.forename: J
authors.initials: J
authors.lastname: Blanche
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D010166:Palliative Care; D010385:Pelvic Exenteration; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D012007:Rectum / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome