title: Outcomes of pelvic exenteration for locally advanced primary rectal cancer: Overall survival and quality of life.
abstract: Radical surgery with pelvic exenteration offers the only potential for cure in patients with locally advanced primary rectal cancer. This study describes the clinical and patient-reported quality of life outcomes over 12 months for patients having pelvic exenteration for locally advanced primary rectal cancer at a specialised centre for pelvic exenteration.
  
  
  
  Clinical data of consecutive patients undergoing pelvic exenteration for locally advanced primary rectal cancer and patient-reported outcomes were collected at baseline, hospital discharge and at 1, 3, 6, 9 and 12 months. Patient-reported outcomes included cancer-specific quality of life (QoL) and physical and mental health status. Quality of life trajectories were modelled over the 12 months from the date of surgery using linear mixed models.
  
  
  
  104 patients with locally advanced rectal cancer underwent pelvic exenteration at Royal Prince Alfred Hospital, Sydney, between December 1994 and October 2014. Complete soft tissue exenteration was performed in 38%. A clear margin was obtained in 86% with a 62% overall five-year survival. QoL outcome questionnaires were completed by 62% of patient cohort. The average FACT-C score returned to pre-surgery QoL by 2 months after surgery, and the average QoL continued to increase slowly over the 12 months.
  
  
  
  Our results support an aggressive approach to advanced primary rectal cancer and lend weight to the oncological role of pelvic exenteration for this group of patients. Quality of life improves rapidly after pelvic exenteration for locally advanced primary rectal cancer and continues to improve over the first year.
authors.affiliation: Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia; Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Quyn
authors.affiliation: Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia; Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia.
authors.forename: K K S
authors.initials: KK
authors.lastname: Austin
authors.affiliation: Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia; Cancer Epidemiology and Cancer Services Research, Sydney School of Public Health, Sydney, New South Wales, 2050, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Young
authors.affiliation: Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia; Cancer Epidemiology and Cancer Services Research, Sydney School of Public Health, Sydney, New South Wales, 2050, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Badgery-Parker
authors.affiliation: Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia.
authors.forename: L M
authors.initials: LM
authors.lastname: Masya
authors.affiliation: Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Roberts
authors.affiliation: Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia; Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, 2050, Australia. Electronic address: professor.solomon@sydney.edu.au.
authors.forename: M J
authors.initials: MJ
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010385:Pelvic Exenteration / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000523:psychology / Q000601:surgery*; D057566:Self Report; D016896:Treatment Outcome
keywords: Cancer; Pelvic exenteration; Quality of life; Rectal