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Total pelvic clearance for advanced pelvic malignancy
Author(s) -
Leon R.,
O’Dwyer S. T.,
Wilson M. S.
Publication year - 2007
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2006.01133_6.x
Subject(s) - medicine , malignancy , surgery , genitourinary system , retrospective cohort study , stage (stratigraphy) , radiation therapy , disease , radiology , paleontology , biology
Objective: Advanced pelvic tumours require multidisciplinary care in order to improve outcome. This is an audit of one specialist unit's experience. Method: Consecutive patients referred from 2001 to 2005 for consideration of pelvic clearance were evaluated by retrospective review. Results: Of 100 patients assessed, 55 were considered unsuitable for surgery. Exclusions included unresectable pelvic side‐wall disease (25), widespread disease (23) and severe co‐morbidity (7). Forty‐five patients were operated on; 22 had locally advanced disease, 14 had recurrence and nine had residual disease following previous surgery. The primary cancers were colorectal in 24, gynaecological in 10 and urogenital in 10; one patient had nonneoplastic disease. Preoperatively 39 (87%) had examination under anaesthetic (87%) and all had MR and CT imaging. Neoadjuvant radiotherapy and chemotherapy was given in 27 and 18 patients respectively. Following resection by a multi‐speciality team, surgery was considered curative in 40 (90%) of cases as judged by a histologically negative margin. All patients received level 2 care postoperatively with only two requiring level 3 care. There was no 30‐day mortality but there were 17 complications treated conservatively and five that required surgery. Conclusion: Advanced pelvic tumours require careful multidisciplinary assessment and treatment. This study shows that this can be done safely with high levels of histological clearance of tumour.