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Pelvic exenteration and rectal cancer

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https://www.readbyqxmd.com/read/30306276/transperineal-retropubic-approach-in-total-pelvic-exenteration-for-advanced-and-recurrent-colorectal-and-anal-cancer-involving-the-penile-base-technique-and-outcomes
#1
A M Mehta, G Hellawell, D Burling, S Littler, A Antoniou, J T Jenkins
BACKGROUND: Complete pathological resection of locally advanced and recurrent anorectal cancer is considered the most important determinant of survival outcome. Involvement of the retropubic space with cancer threatening or involving the penile base poses specific challenges due to the potential for margin involvement and blood loss from the dorsal venous plexus. In the present study we evaluate a new transperineal surgical approach to excision of anterior compartment organs involved or threatened by cancer which facilitates exposure and visualisation of the bulbar urethra and the deep vein of the penis caudal to the retropubic space and penile base...
October 10, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/30263984/cohort-study-of-long-term-survival-and-quality-of-life-following-pelvic-exenteration
#2
D Steffens, M J Solomon, J M Young, C Koh, R L Venchiarutti, P Lee, K Austin
Background: Pelvic exenteration (PE) is the preferred treatment available for selected patients diagnosed with locally advanced or recurrent cancer confined to the pelvis. Currently, the majority of the literature reports only on short-term survival and quality-of-life (QoL) outcomes. The aim of this prospective cohort study was to describe long-term survival and QoL outcomes following PE. Methods: This was a cohort study of consecutive patients undergoing PE from 1994 to 2016 at a major teaching hospital in Sydney, Australia...
September 2018: BJS open
https://www.readbyqxmd.com/read/30184598/-the-significance-of-palliative-surgery-in-castration-resistant-prostate-cancer
#3
Friederike Haidl, Axel Heidenreich
If prostate cancer recurs after primary treatment, deprivation therapy with LHRH analogues or antagonists is the treatment of choice in men with metastatic prostate cancer. However, this treatment only achieves palliative results. Median time to progression ranges between 11 and 78 months. After the introduction of Docetaxel as a first-line treatment in castration-resistant prostate cancer (CRPCA) and cabazitaxel as a second-line chemotherapy, several new drugs containing abiraterone, enzalutamide, radium 223 and sipuleucel-T have become available, which can lead to complete or partial remissions in metastasis, but do not have an effect on the prostate itself as has been shown recently...
September 2018: Aktuelle Urologie
https://www.readbyqxmd.com/read/30075979/total-pelvic-exenteration-for-locally-advanced-and-locally-recurrent-rectal-cancer-in-the-elderly
#4
J A W Hagemans, J Rothbarth, W J Kirkels, J L Boormans, E van Meerten, J J M E Nuyttens, E V E Madsen, C Verhoef, J W A Burger
BACKGROUND: Total pelvic exenteration (TPE) is a radical approach for locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) in case of tumour invasion into the urogenitary tract. The aim of this study is to assess surgical and oncological outcomes of TPE for LARC and LRRC in elderly patients compared to younger patients. METHODS: All patients who underwent TPE for LARC and LRRC between January 1990 and March 2017 were retrospectively analyzed...
October 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29985547/persistent-involvement-of-anterior-mesorectal-fascia-in-carcinoma-rectum-extended-resection-of-rectum-vs-total-pelvic-exenteration-results-from-a-single-centre-retrospective-study
#5
K Verma, R Engineer, V Ostwal, S Kumar, S Arya, A L Desouza, A P Saklani
AIM: Involvement of the anterior mesorectal fascia (iAMRF) after neoadjuvant treatment leads to either resection of the involved organ alone [extended resection of the rectum (ERR)] or total pelvic exenteration (TPE). The purpose of this study was to compare the rate of recurrence and survival of patients undergoing ERR or TPE for iAMRF after neoadjuvant treatment. The outcome of patients who underwent total mesorectal excision after downstaging was also compared. METHOD: This was a retrospective study of primary rectal cancer patients...
July 9, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29920909/a-qualitative-study-of-the-development-of-a-multidisciplinary-case-conference-review-methodology-to-reduce-involved-margins-in-pelvic-exenteration-surgery-for-recurrent-rectal-cancer
#6
G H van Ramshorst, S O'Shannassy, W E Brown, J G Kench, M J Solomon
AIM: Pelvic exenteration surgery remains the only curative option for recurrent rectal cancer. Microscopically involved surgical margins (R1) are associated with a higher risk of local recurrence and decreased survival. Our study aimed to develop a post hoc multidisciplinary case conference review and investigate its potential for identifying areas for improvement. METHOD: Patients who underwent pelvic exenteration surgery for recurrent rectal cancer with R1 resections at a tertiary referral centre between April 2014 and January 2016 were retrospectively reviewed from a prospectively maintained database...
June 19, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29741977/laparoscopic-pelvic-exenteration-for-locally-advanced-rectal-cancer-technique-and-short-term-outcomes
#7
Ashish Pokharkar, Praveen Kammar, Ashwin D'souza, Rahul Bhamre, Pavan Sugoor, Avanish Saklani
BACKGROUND: Since last two decades minimally invasive techniques have revolutionized surgical field. In 2003 Pomel first described laparoscopic pelvic exenteration, since then very few reports have described minimally invasive approaches for total pelvic exenteration. METHODS: We report the 10 cases of locally advanced rectal adenocarcinoma which were operated between the periods from March 1, 2017 to November 11, 2017 at the Tata Memorial Hospital, Mumbai. All male patients had lower rectal cancer with prostate involvement on magnetic resonance imaging (MRI)...
May 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29721748/oncological-outcomes-of-robotic-assisted-laparoscopic-versus-open-lateral-lymph-node-dissection-for-locally-advanced-low-rectal-cancer
#8
Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Akinobu Furutani, Shoichi Manabe, Yusuke Yamaoka, Hitoshi Hino
BACKGROUND: The long-term outcomes of robotic-assisted laparoscopic lateral lymph node dissection (RALLD) have not been fully investigated. This study aimed to assess the oncological and long-term outcomes of RALLD for rectal cancer through comparison with those of open lateral lymph node dissection (OLLD) in a retrospective study. METHODS: Between September 2002 and October 2014, the medical data of 426 patients who underwent total mesorectal excision with lateral lymph node dissection for primary rectal cancer were collected...
November 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29624550/urgent-pelvic-exenteration-should-the-indication-be-extended
#9
COMPARATIVE STUDY
Charnjiroj Thiptanakit, Irin Chowchankit, Sirinya Panya, Prapon Kanjanasilp, Songphol Malakorn, Jirawat Pattana-Arun, Chucheep Sahakitrungruang
BACKGROUND: Pelvic exenteration carries significant risks of morbidity and mortality. Preoperative management is therefore crucial, and the exenteration procedure is usually performed in an elective setting. In cases of rectal cancer, however, tumor-related complications may cause a patient's condition to deteriorate rapidly, despite optimal management. Urgent pelvic exenteration then may be an option for these patients. OBJECTIVE: This study aims to compare the outcomes of pelvic exenteration between the urgent and elective settings...
May 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29529336/factors-affecting-outcomes-following-pelvic-exenteration-for-locally-recurrent-rectal-cancer
#10
(no author information available yet)
BACKGROUND: Pelvic exenteration for locally recurrent rectal cancer (LRRC) is associated with variable outcomes, with the majority of data from single-centre series. This study analysed data from an international collaboration to determine robust parameters that could inform clinical decision-making. METHODS: Anonymized data on patients who had pelvic exenteration for LRRC between 2004 and 2014 were accrued from 27 specialist centres. The primary endpoint was survival...
May 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29510462/development-of-a-pelvic-exenteration-service-at-a-tertiary-referral-centre
#11
Marilla Dickfos, Stephanie B M Tan, Andrew R L Stevenson, Craig A Harris, Rachel Esler, Matthew Peters, David G Taylor
BACKGROUND: Over one-third of primary rectal cancers are locally advanced at diagnosis, and local recurrence of rectal cancer occurs at a rate of 3-10% following primary curative resection. Extended resectional surgery, including pelvic exenteration, is the only proven therapy with curative potential in the treatment of these cancers along with many other pelvic malignancies. A microscopically clear resection margin (R0 resection) is the predominant prognostic factor affecting overall and disease-free survival...
March 6, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29394675/-a-case-of-locally-advanced-rectal-cancer-with-abscess-and-rectovesical-fistula-curatively-resected-following-preoperative-chemotherapy
#12
Tatsuya Matsumoto, Masayoshi Nakanishi, Mahito Miyamae, Koji Takao, Tomohiko Fukunaga, Eigo Otsuji
A 63-year-old man with bloody stools, anal incompetence, and feeling of fatigue was diagnosed as having a RAS mutanttype rectal cancer with abscess and rectovesical fistula. Computed tomography revealed that the tumor had invaded the seminal vesicle, prostate, and bladder and formed an abscess. In addition, his general condition was poor. Thus, we evaluated the lesion as unresectable. His nutritional status improved, and the infection was controlled after colostomy. Then, we performed chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin(FOLFOX)plus bevacizumab...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394612/-utility-of-preoperative-chemotherapy-for-locally-advanced-colorectal-cancer
#13
Nobuhiro Takiguchi, Hiroaki Soda, Toru Tonooka, Atsushi Ikeda, Yoshihiro Nabeya, Isamu Hoshino, Ryotaro Teranaka, Tadamichi Denda
Preoperative chemotherapy has been performed for locally advanced colorectal cancer, to achieve cytoreduction, local control, and prevention of distant metastasis. The regimens of mFOLFOX6/XELOX plus bevacizumab for 3 months have been adopted to succeed curative resection for borderline resectable colorectal cancer. We examined treatment results for locally advanced colorectal cancer without distant metastasis. Thirty-four patients were examined and the mean age was 62.7 years old. The cohort comprised of 23 cases of rectal cancer and 11 of sigmoid colon cancer...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29362344/-a-case-of-rectal-cancer-with-multiple-pulmonary-and-liver-metastases-could-be-resected-through-chemotherapy
#14
Masatoshi Nomura, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
The patient was a 47-year-old man, whose chief complaint was melena. He visited a nearby hospital, and further evaluation showed rectal cancer invading the prostate, with multiple lung and liver metastases. The clinical diagnosis was cT4b(prostate), cN1, cM1b(H2, PUL2), cStage IV . We performed colostomy in the transverse colon prior to chemotherapy. He was administered 1 course of mFOLFOX6 plus bevacizumab and 7 courses of FOLFOXIRI plus bevacizumab. The primary tumor showed PR. The liver metastases were localized and shrunken, while the lung metastases disappeared...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29229359/pelvic-exenteration-with-rectal-resection-for-different-types-of-malignancies-at-two-tertiary-referral-centres
#15
Alvaro Garcia-Granero, Sebastiano Biondo, Eloy Espin-Basany, Ana González-Castillo, Silvia Valverde, Loris Trenti, Antonio Gil-Moreno, Esther Kreisler
INTRODUCTION: Pelvic exenteration (PE) offers the best chance of cure for locally advanced primary or recurrent pelvic organ malignancies invading adjacent organs. The aims of this study were to analyse results for any pelvic exenteration that includes rectal resection and the analysis of results of fecal and urinary reconstruction. METHOD: From January 2000 to April 2014, 111 PE with rectal resection for any pelvic cancer were analysed retrospectively at two national tertiary referral centers...
March 2018: Cirugía Española
https://www.readbyqxmd.com/read/28987560/outcomes-of-pelvic-exenteration-for-recurrent-and-primary-locally-advanced-rectal-cancer
#16
Matteo Rottoli, Carlo Vallicelli, Luca Boschi, Gilberto Poggioli
BACKGROUND: Pelvic exenteration is the only radical treatment for locally advanced (ARC) or recurrent (RRC) rectal cancers. The long-term results of the procedure are variably reported in the literature, with recent series suggesting similar survival between ARC and RRC. The study aimed to analyze and compare the long-term survival and perioperative outcomes of patients undergoing pelvic exenteration for ARC and RRC in a tertiary center. MATERIALS AND METHODS: This was a retrospective analysis of prospectively collected data...
December 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28982515/robotic-total-pelvic-exenteration-with-intracorporeal-sigmoid-conduit-and-colostomy-step-by-step-technique
#17
Matthew J Maurice, Daniel Ramirez, Emre Gorgun, Georges-Pascal Haber
OBJECTIVE: To describe our technique for robotic total pelvic exenteration with intracorporeal sigmoid conduit and colostomy using the da Vinci Si robot. METHODS: Three 8-mm robotic ports and two 12-mm laparoscopic ports are placed in a "W" configuration, approximately 2-3 cm more cephalad than for radical prostatectomy (Fig. 1). The robot is docked between the legs with the patient in steep Trendelenburg. The ureters are dissected out from the iliac vessels to the rectovesical pouch, where they are clipped and transected...
July 2017: Urology
https://www.readbyqxmd.com/read/28938268/surgical-and-survival-outcomes-following-pelvic-exenteration-for-locally-advanced-primary-rectal-cancer-results-from-an-international-collaboration
#18
(no author information available yet)
OBJECTIVE: The aim of the study was to analyze data from an international collaboration, and ascertain prognostic indicators that inform clinical decision-making and practices regarding the role of pelvic exenteration for locally advanced primary rectal cancer (LARC). BACKGROUND: With improved national screening programs fewer patients present with LARC. Despite this, select cohorts of patients require pelvic exenteration. To date, the majority of outcome data are from single-center series...
September 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28924962/the-impact-of-tumour-distance-from-the-anal-verge-on-clinical-management-and-outcomes-in-patients-having-a-curative-resection-for-rectal-cancer
#19
Muhammad Amir Saeed Khan, Chin W Ang, Abdul Rahman Hakeem, Nigel Scott, Rick Nigel Saunders, Ian Botterill
AIM: The clinico-oncological significance of the distance of rectal cancer from the anal verge is unclear and not well reported. The aim of this study is to assess the influence of the rectal cancer distance from the anal verge on clinical management and long-term outcomes after curative resection in a specialised colorectal cancer unit. METHODS: Prospectively collected data on patients who underwent primary rectal cancer treatment at our unit between January 2005 and December 2010 were analysed...
December 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28682968/prognostic-impact-of-intra-abdominal-pelvic-inflammation-after-radical-surgery-for-locally-recurrent-rectal-cancer
#20
Masahiro Tanaka, Yukihide Kanemitsu, Dai Shida, Hiroki Ochiai, Shunsuke Tsukamoto, Masato Nagino, Yoshihiro Moriya
BACKGROUND: The influence of postoperative infectious complications, such as anastomotic leakage, on survival has been reported for various cancers, including colorectal cancer. However, it remains unclear whether intra-abdominal/pelvic inflammation after radical surgery for locally recurrent rectal cancer is relevant to its prognosis. OBJECTIVE: The purpose of this study was to evaluate factors associated with survival after radical surgery for locally recurrent rectal cancer...
August 2017: Diseases of the Colon and Rectum
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