Locally Advanced Disease and Pelvic Exenterations

Abstract

Advanced primary and recurrent colorectal cancer can be successfully treated by experienced, dedicated centers delivering good outcomes with low mortality and morbidity. Development and implementation of a comprehensive referral pathway is to be encouraged. Multidisciplinary team management is essential in the management of this complex group of patients and is associated with significantly more complete preoperative evaluation and more accurate provision of patient information, as well as improved access to the most appropriate individualized management plan. A structured selection process can improve outcomes through standardized approaches to service delivery to provide the highest quality of care.

Keywords

primary advanced rectal cancer - recurrent rectal cancer - beyond total mesorectal excision - multidisciplinary management

• Reference

• 1 Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J. , et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 2013; 49 (06) 1374-1403
• 2 Meyer JE, Narang T, Schnoll-Sussman FH, Pochapin MB, Christos PJ, Sherr DL. Increasing incidence of rectal cancer in patients aged younger than 40 years: an analysis of the surveillance, epidemiology, and end results database. Cancer 2010; 116 (18) 4354-4359
• 3 MERCURY Study Group. Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ 2006; 333 (7572): 779
• 4 Solum AM, Riffenburgh RH, Johnstone PA. Survival of patients with untreated rectal cancer. J Surg Oncol 2004; 87 (04) 157-161
• 5 Carlsson U, Lasson A, Ekelund G. Recurrence rates after curative surgery for rectal carcinoma, with special reference to their accuracy. Dis Colon Rectum 1987; 30 (06) 431-434
• 6 Arnott SJ. The value of combined 5-fluorouracil and x-ray therapy in the palliation of locally recurrent and inoperable rectal carcinoma. Clin Radiol 1975; 26 (02) 177-182
• 7 MacFarlane JK, Ryall RD, Heald RJ. Mesorectal excision for rectal cancer. Lancet 1993; 341 (8843): 457-460
• 8 van Gijn W, Marijnen CA, Nagtegaal ID. , et al; Dutch Colorectal Cancer Group. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011; 12 (06) 575-582
• 9 Sagar PM, Pemberton JH. Surgical management of locally recurrent rectal cancer. Br J Surg 1996; 83 (03) 293-304
• 10 Ito Y, Ohtsu A, Ishikura S. , et al. Efficacy of chemoradiotherapy on pain relief in patients with intrapelvic recurrence of rectal cancer. Jpn J Clin Oncol 2003; 33 (04) 180-185
• 11 Nielsen MB, Rasmussen PC, Lindegaard JC, Laurberg S. A 10-year experience of total pelvic exenteration for primary advanced and locally recurrent rectal cancer based on a prospective database. Colorectal Dis 2012; 14 (09) 1076-1083
• 12 Bhangu A, Ali SM, Darzi A, Brown G, Tekkis P. Meta-analysis of survival based on resection margin status following surgery for recurrent rectal cancer. Colorectal Dis 2012; 14 (12) 1457-1466
• 13 Heriot AG, Byrne CM, Lee P. , et al. Extended radical resection: the choice for locally recurrent rectal cancer. Dis Colon Rectum 2008; 51 (03) 284-291
• 14 Beyond TME Collaborative. Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes. Br J Surg 2013; 100 (08) E1-E33
• 15 Tepper JE, O'Connell M, Hollis D, Niedzwiecki D, Cooke E, Mayer RJ. ; Intergroup Study 0114. Analysis of surgical salvage after failure of primary therapy in rectal cancer: results from Intergroup Study 0114. J Clin Oncol 2003; 21 (19) 3623-3628
• 16 Ngan SY, Fisher R, Burmeister BH. , et al. Promising results of a cooperative group phase II trial of preoperative chemoradiation for locally advanced rectal cancer (TROG 9801). Dis Colon Rectum 2005; 48 (07) 1389-1396
• 17 Krook JE, Moertel CG, Gunderson LL. , et al. Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 1991; 324 (11) 709-715
• 18 Salerno G, Daniels IR, Brown G. Magnetic resonance imaging of the low rectum: defining the radiological anatomy. Colorectal Dis 2006; 8 (Suppl. 03) 10-13
• 19 Siegel R, Burock S, Wernecke KD. , et al. Preoperative short-course radiotherapy versus combined radiochemotherapy in locally advanced rectal cancer: a multi-centre prospectively randomised study of the Berlin Cancer Society. BMC Cancer 2009; 9: 50
• 20 Pilipshen SJ, Heilweil M, Quan SH, Sternberg SS, Enker WE. Patterns of pelvic recurrence following definitive resections of rectal cancer. Cancer 1984; 53 (06) 1354-1362
• 21 Ogunbiyi OA, McKenna K, Birnbaum EH, Fleshman JW, Kodner IJ. Aggressive surgical management of recurrent rectal cancer--is it worthwhile?. Dis Colon Rectum 1997; 40 (02) 150-155
• 22 Sauer R, Liersch T, Merkel S. , et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol 2012; 30 (16) 1926-1933
• 23 Van Cutsem E, Dicato M, Haustermans K. , et al. The diagnosis and management of rectal cancer: expert discussion and recommendations derived from the 9th World Congress on Gastrointestinal Cancer, Barcelona, 2007. Ann Oncol 2008; 19 (Suppl. 06) vi1-vi8
• 24 Denost Q, Kontovounisios C, Rasheed S. , et al. Individualizing surgical treatment based on tumour response following neoadjuvant therapy in T4 primary rectal cancer. Eur J Surg Oncol 2017; 43 (01) 92-99
• 25 Hashiguchi Y, Sekine T, Sakamoto H. , et al. Intraoperative irradiation after surgery for locally recurrent rectal cancer. Dis Colon Rectum 1999; 42 (07) 886-893 , discussion 893–895
• 26 Kusters M, Valentini V, Calvo FA. , et al. Results of European pooled analysis of IORT-containing multimodality treatment for locally advanced rectal cancer: adjuvant chemotherapy prevents local recurrence rather than distant metastases. Ann Oncol 2010; 21 (06) 1279-1284
• 27 Dubois JB, Bussieres E, Richaud P. , et al. Intra-operative radiotherapy of rectal cancer: results of the French multi-institutional randomized study. Radiother Oncol 2011; 98 (03) 298-303
• 28 van Stiphout RG, Lammering G, Buijsen J. , et al. Development and external validation of a predictive model for pathological complete response of rectal cancer patients including sequential PET-CT imaging. Radiother Oncol 2011; 98 (01) 126-133
• 29 Cammà C, Giunta M, Fiorica F, Pagliaro L, Craxì A, Cottone M. Preoperative radiotherapy for resectable rectal cancer: a meta-analysis. JAMA 2000; 284 (08) 1008-1015
• 30 Genovesi D, Myerson RJ, Cèfaro GA. , et al; G.I. A.I.R.O. Working Group. Postoperative 5-FU based radiochemotherapy in rectal cancer: retrospective long term results and prognostic factors of a pooled analysis on 1,338 patients. Anticancer Res 2013; 33 (10) 4557-4566
• 31 Brunschwig A. Complete excision of pelvic viscera for advanced carcinoma; a one-stage abdominoperineal operation with end colostomy and bilateral ureteral implantation into the colon above the colostomy. Cancer 1948; 1 (02) 177-183
• 32 Dresen RC, Gosens MJ, Martijn H. , et al. Radical resection after IORT-containing multimodality treatment is the most important determinant for outcome in patients treated for locally recurrent rectal cancer. Ann Surg Oncol 2008; 15 (07) 1937-1947
• 33 Bouchard P, Efron J. Management of recurrent rectal cancer. Ann Surg Oncol 2010; 17 (05) 1343-1356
• 34 Pawlik TM, Skibber JM, Rodriguez-Bigas MA. Pelvic exenteration for advanced pelvic malignancies. Ann Surg Oncol 2006; 13 (05) 612-623
• 35 Suzuki K, Dozois RR, Devine RM. , et al. Curative reoperations for locally recurrent rectal cancer. Dis Colon Rectum 1996; 39 (07) 730-736
• 36 Yamada K, Ishizawa T, Niwa K, Chuman Y, Akiba S, Aikou T. Patterns of pelvic invasion are prognostic in the treatment of locally recurrent rectal cancer. Br J Surg 2001; 88 (07) 988-993
• 37 Mohiuddin M, Marks GM, Lingareddy V, Marks J. Curative surgical resection following reirradiation for recurrent rectal cancer. Int J Radiat Oncol Biol Phys 1997; 39 (03) 643-649
• 38 Wasserman K. Diagnosing cardiovascular and lung pathophysiology from exercise gas exchange. Chest 1997; 112 (04) 1091-1101
• 39 Belardinelli R, Lacalaprice F, Carle F. , et al. Exercise-induced myocardial ischaemia detected by cardiopulmonary exercise testing. Eur Heart J 2003; 24 (14) 1304-1313
• 40 Abbas SM, Hill AG. Systematic review of the literature for the use of oesophageal Doppler monitor for fluid replacement in major abdominal surgery. Anaesthesia 2008; 63 (01) 44-51
• 41 Bhangu A, Ali SM, Brown G, Nicholls RJ, Tekkis P. Indications and outcome of pelvic exenteration for locally advanced primary and recurrent rectal cancer. Ann Surg 2014; 259 (02) 315-322
• 42 Schneider A, Köhler C, Erdemoglu E. Current developments for pelvic exenteration in gynecologic oncology. Curr Opin Obstet Gynecol 2009; 21 (01) 4-9
• 43 Austin KK, Solomon MJ. Pelvic exenteration with en bloc iliac vessel resection for lateral pelvic wall involvement. Dis Colon Rectum 2009; 52 (07) 1223-1233
• 44 Zoucas E, Frederiksen S, Lydrup ML, Månsson W, Gustafson P, Alberius P. Pelvic exenteration for advanced and recurrent malignancy. World J Surg 2010; 34 (09) 2177-2184
• 45 Ramirez PT, Modesitt SC, Morris M. , et al. Functional outcomes and complications of continent urinary diversions in patients with gynecologic malignancies. Gynecol Oncol 2002; 85 (02) 285-291
• 46 Buchel EW, Finical S, Johnson C. Pelvic reconstruction using vertical rectus abdominis musculocutaneous flaps. Ann Plast Surg 2004; 52 (01) 22-26
• 47 Kakuda JT, Lamont JP, Chu DZ, Paz IB. The role of pelvic exenteration in the management of recurrent rectal cancer. Am J Surg 2003; 186 (06) 660-664
• 48 Saito N, Koda K, Takiguchi N. , et al. Curative surgery for local pelvic recurrence of rectal cancer. Dig Surg 2003; 20 (03) 192-199 , discussion 200
• 49 Nishio M, Sakakura C, Nagata T. , et al. Outcomes of total pelvic exenteration for colorectal cancer. Hepatogastroenterology 2009; 56 (96) 1637-1641
• 50 Wells BJ, Stotland P, Ko MA. , et al. Results of an aggressive approach to resection of locally recurrent rectal cancer. Ann Surg Oncol 2007; 14 (02) 390-395
• 51 Boyle KM, Sagar PM, Chalmers AG, Sebag-Montefiore D, Cairns A, Eardley I. Surgery for locally recurrent rectal cancer. Dis Colon Rectum 2005; 48 (05) 929-937
• 52 Wanebo HJ, Antoniuk P, Koness RJ. , et al. Pelvic resection of recurrent rectal cancer: technical considerations and outcomes. Dis Colon Rectum 1999; 42 (11) 1438-1448
• 53 Ferenschild FT, Vermaas M, Verhoef C. , et al. Total pelvic exenteration for primary and recurrent malignancies. World J Surg 2009; 33 (07) 1502-1508
• 54 Houvenaeghel G, Moutardier V, Karsenty G. , et al. Major complications of urinary diversion after pelvic exenteration for gynecologic malignancies: a 23-year mono-institutional experience in 124 patients. Gynecol Oncol 2004; 92 (02) 680-683
• 55 Jimenez RE, Shoup M, Cohen AM, Paty PB, Guillem J, Wong WD. Contemporary outcomes of total pelvic exenteration in the treatment of colorectal cancer. Dis Colon Rectum 2003; 46 (12) 1619-1625
• 56 Grossmann I, de Bock GH, Meershoek-Klein Kranenbarg WM, van de Velde CJ, Wiggers T. Carcinoembryonic antigen (CEA) measurement during follow-up for rectal carcinoma is useful even if normal levels exist before surgery. A retrospective study of CEA values in the TME trial. Eur J Surg Oncol 2007; 33 (02) 183-187
• 57 Young JM, Badgery-Parker T, Masya LM. , et al. Quality of life and other patient-reported outcomes following exenteration for pelvic malignancy. Br J Surg 2014; 101 (03) 277-287
• 58 Yang TX, Morris DL, Chua TC. Pelvic exenteration for rectal cancer: a systematic review. Dis Colon Rectum 2013; 56 (04) 519-531
• 59 Thaysen HV, Jess P, Laurberg S. Health-related quality of life after surgery for primary advanced rectal cancer and recurrent rectal cancer: a review. Colorectal Dis 2012; 14 (07) 797-803
• 60 You YN, Habiba H, Chang GJ, Rodriguez-bigas MA, Skibber JM. Prognostic value of quality of life and pain in patients with locally recurrent rectal cancer. Ann Surg Oncol 2011; 18 (04) 989-996