Outcomes of total pelvic exenteration for colorectal cancer.

Background/Aims: Pelvic recurrence occurs in 4-33% of patients who have undergone a curative resection of primary rectal cancer and is thus a serious problem. However, the best treatment for primary rectal cancer remains unclear. In the present study was assessed the outcomes of total pelvic exenteration for colorectal cancer retrospectively. Methodology: In the present study was investigated the medical charts of 25 patients who underwent total pelvic exenteration for primary colorectal cancer (n=12) or postoperative local recurrence of colorectal cancer (n= 13 ) at the Department of Surgery (Division of Digestive Surgery) of the Kyoto Prefectural University of Medicine between the years 1997-2005. Results: The mean disease-free time interval between the first operation for primary colorectal cancer and total pelvic exenteration for the recurrence was 919 days (range, 203-3460 days). Total pelvic exenteration required a mean operation time of 940 minutes (range, 540-1395 minutes). The mean carcinoembryonic antigen (CEA) value was 25.5ng/ml (range, 1-171.8ng/ml). Five-year survival was achieved in 9 patients (36%) and in-hospital death occurred in 3 patients (12%). The patients with curative resection survived significantly longer than the patients with non-curative resection. Conclusions: When curative resection is achieved, total pelvic exenteration for colorectal cancer can result in long-term survival.