Changing outcomes following pelvic exenteration for locally advanced and recurrent rectal cancer

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PelvEx Collaborative

Abstract

Pelvic exenteration for locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) is technically challenging but increasingly performed in specialist centres. The aim of this study was to compare outcomes of exenteration over time. This was a multicentre retrospective study of patients who underwent exenteration for LARC and LRRC between 2004 and 2015. Surgical outcomes, including rate of bone resection, flap reconstruction, margin status and transfusion rates, were examined. Outcomes between higher- and lower-volume centres were also evaluated. Some 2472 patients underwent pelvic exenteration for LARC and LRRC across 26 institutions. For LARC, rates of bone resection or flap reconstruction increased from 2004 to 2015, from 3·5 to 12·8 per cent, and from 12·0 to 29·4 per cent respectively. Fewer units of intraoperative blood were transfused over this interval (median 4 to 2 units; P = 0·040). Subgroup analysis showed that bone resection and flap reconstruction rates increased in lower- and higher-volume centres. R0 resection rates significantly increased in low-volume centres but not in high-volume centres over time (low-volume: from 62·5 to 80·0 per cent, P = 0·001; high-volume: from 83·5 to 88·4 per cen...Continue Reading

References

Feb 19, 1999·Medical Care·S R FinlaysonR F Nease
Jul 16, 2003·Archives of Surgery·Emily V A FinlaysonJohn D Birkmeyer
Nov 25, 2003·Annals of Surgery·Ingemar Ihse
Dec 4, 2003·JAMA : the Journal of the American Medical Association·John D BirkmeyerDavid C Goodman
Apr 26, 2007·Annals of Surgery·John D BirkmeyerTherese A Stukel
Jun 14, 2008·Surgery·Gauthier BouchePierre Ingrand
Mar 30, 2012·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Johan L DikkenMichel W J M Wouters
Mar 20, 2015·Annals of Surgery·Lieke GietelinkUNKNOWN Dutch Surgical Colorectal Cancer Audit Group
Nov 19, 2015·Surgery·Christopher T AquinaJohn R T Monson
Apr 7, 2016·The New England Journal of Medicine·Andrea L MerrillJustin B Dimick
Sep 8, 2016·Diseases of the Colon and Rectum·Amanda C R K BosValery E P P Lemmens
Jun 20, 2017·Annals of Surgery·J Gregory ModrallEric B Rosero

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Citations

Oct 22, 2019·Annals of Surgery·UNKNOWN PelvExCollaborative
Sep 15, 2019·Annals of Surgical Oncology·Michael J Solomon, Kilian G M Brown
Jul 25, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·E M BurnsUNKNOWN UK PEN (United Kingdom Pelvic Exenteration Network)
Aug 14, 2020·The British Journal of Surgery·Q DenostF Saillour-Glénisson
Sep 27, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Kilian G M BrownChristopher J Young
Jan 19, 2021·The British Journal of Surgery·UNKNOWN PelvEx Collaborative
Apr 3, 2021·Surgical Oncology·Kheng-Seong Ng, Peter J M Lee
Apr 13, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Quentin DenostUNKNOWN on behalf the GRECCAR Group

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