Abdominosacral resection for locally advanced and recurrent rectal cancer

Floris Ferenschild, Maarten Vermaas, Kees Verhoef, Roy Dwarkasing, Lex Eggermont, JHW (Johannes) de Wilt

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Background: The results of resection of locally advanced and recurrent rectal cancers, including sacral resection, were analysed critically. Methods: Between 1987 and 2007, 353 patients with locally advanced or recurrent rectal cancer, all treated in a tertiary referral centre, were identified from a prospective database. Twenty-five patients (eight primary and 17 recurrent tumours) underwent en bloc sacral resection. Results: A mid-sacral resection was carried out in 12 patients (level S3) and a low sacral resection in 13 (level S4/S5). Nineteen patients had an R0, four R1 and two an R2 resection. There was no postoperative mortality. Median follow-up was 32 months. Incomplete resection had all independent negative influence oil local control (5-year local recurrence rate 42 versus 0 per cent in those with and without incomplete resection; P < 0.001). The 5-year overall survival rate was 30 per cent. Five patients with recurrent turnout had pathological invasion into the sacral bone and none survived beyond 1 year. Conclusion: Abdominosacral resection can be performed in patients with locally advanced and recurrent rectal cancer. Patients who cannot undergo a complete resection or have clear evidence of cortical invasion have a poor prognosis.
Original languageUndefined/Unknown
Pages (from-to)1341-1347
Number of pages7
JournalBritish Journal of Surgery
Issue number11
Publication statusPublished - 2009

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