title: Abdominosacral resection: long-term outcome in 86 patients with locally advanced or locally recurrent rectal cancer.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the outcome of abdominosacral resections (ASR) in patients with locally advanced or recurrent rectal cancer.
  
  
  METHODS
  From 1994 until 2012 patients with locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) underwent a curative ASR and were enrolled in a database. The postoperative complication rates, predictive factors on oncological outcome and survival rates were registered.
  
  
  RESULTS
  Seventy-two patients with LRRC (mean age 63; 44 male, 28 female) and 14 patients with LARC (mean age 65; 6 male, 8 female) underwent ASR. R0 resection was achieved in 37 patients with LRRC and 11 patients with LARC. Twenty-seven patients underwent an R1 resection (3 in the LARC group). Eight patients had an R2 resection, compared to no patients in the LARC group. In respectively 26 and 1 patients of the LRRC and LARC groups a grade 3 or 4 complication occurred and the 30-days mortality rate was respectively 3% and 7%. The 5-years overall survival was 28% and 24% respectively.
  
  
  CONCLUSIONS
  En bloc radical resection remains the primary goal in the treatment of dorsally located (recurrent) rectal cancer. After thorough patient selection, ASR is a safe procedure to perform, shows acceptable morbidity rates and leads to a good oncological outcome.
authors.affiliation: Department of Colorectal Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: S J
authors.initials: SJ
authors.lastname: Bosman
authors.affiliation: Department of Colorectal Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: T A
authors.initials: TA
authors.lastname: Vermeer
authors.affiliation: Intensive Care Department, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: R L
authors.initials: RL
authors.lastname: Dudink
authors.affiliation: Department of Colorectal Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: I H J T
authors.initials: IH
authors.lastname: de Hingh
authors.affiliation: Department of Colorectal Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: G A P
authors.initials: GA
authors.lastname: Nieuwenhuijzen
authors.affiliation: Department of Colorectal Surgery, Catharina Hospital, Eindhoven, The Netherlands; Department of Surgery, Maastricht University, Maastricht, The Netherlands. Electronic address: harm.rutten@cze.nl.
authors.forename: H J T
authors.initials: HJ
authors.lastname: Rutten
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications; D016684:Prone Position; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Abdominosacral resection; Complications; Locally advanced rectal cancer; Locally recurrent rectal cancer; Oncological outcome