title: A systematic review examining quality of life following pelvic exenteration for locally advanced and recurrent rectal cancer.
abstract: OBJECTIVE
  Pelvic exenteration is a complex surgical procedure associated with considerable morbidity. Quality of life (QoL) is a crucial metric of surgical outcome. The aim of this review was to assess the QoL following pelvic exenteration for locally advanced rectal cancer (LARC) and local recurrent rectal cancer (LRRC).
  
  
  METHODS
  A comprehensive search of studies published between 2000 and 2016 that examined QoL outcome following pelvic exenteration was performed. Functional Assessment of Cancer Therapy - Colorectal (FACT-C), SF-36 version 2, European Organization for Research and Treatment of Cancer QLQ-C30, and Brief Pain Inventory assessments from these studies were reviewed.
  
  
  RESULTS
  Seven studies reporting on 382 patients were included. Baseline QoL was the strongest predictor of postoperative QoL. Female gender, total pelvic exenteration with or without bone resection, and positive surgical margins were associated with a reduced QoL. In the majority of patients, QoL gradually improved between 2 and 9 months post-operation.
  
  
  CONCLUSIONS
  QoL is an important patient-reported outcome. This review highlights factors associated with reduced postoperative QoL that should be borne in mind when surgical resection is being considered.
authors.affiliation: Department of Colorectal Surgery, St Vincent's University Hospital, Elm Park, Dublin, Ireland.|Department of Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, San Donato Milanese (Milano), Italy.
authors.forename: E
authors.initials: E
authors.lastname: Rausa
authors.affiliation: Department of Colorectal Surgery, St Vincent's University Hospital, Elm Park, Dublin, Ireland.
authors.forename: M E
authors.initials: ME
authors.lastname: Kelly
authors.affiliation: Department of Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, San Donato Milanese (Milano), Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bonavina
authors.affiliation: Department of Colorectal Surgery, St Vincent's University Hospital, Elm Park, Dublin, Ireland.|Section of Surgery, UCD School of Medicine, Dublin, Ireland.
authors.forename: P R
authors.initials: PR
authors.lastname: O'Connell
authors.affiliation: Department of Colorectal Surgery, St Vincent's University Hospital, Elm Park, Dublin, Ireland.|Section of Surgery, UCD School of Medicine, Dublin, Ireland.
authors.forename: D C
authors.initials: DC
authors.lastname: Winter
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D010385:Pelvic Exenteration / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology*; D011184:Postoperative Period; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Rectal cancer; pelvic exenteration; quality of life; recurrent neoplasm; surgical outcomes