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International Journal of Surgical Oncology
Volume 2011, Article ID 678506, 9 pages
http://dx.doi.org/10.1155/2011/678506
Review Article

Selection Criteria for the Radical Treatment of Locally Advanced Rectal Cancer

1Department of Colorectal Surgery, Singleton Hospital, Swansea SA2 8QA, UK
2Department of Urology, Morriston Hospital, Swansea SA6 6NL, UK
3Department of Plastic Surgery, Morriston Hospital, Swansea SA6 6NL, UK

Received 15 December 2010; Revised 30 June 2011; Accepted 18 July 2011

Academic Editor: Michael Hünerbein

Copyright © 2011 Mansel Leigh Davies et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There are over 14,000 newly diagnosed rectal cancers per year in the United Kingdom of which between 50 and 64 percent are locally advanced (T3/T4) at presentation. Pelvic exenterative surgery was first described by Brunschwig in 1948 for advanced cervical cancer, but early series reported high morbidity and mortality. This approach was later applied to advanced primary rectal carcinomas with contemporary series reporting 5-year survival rates between 32 and 66 percent and to recurrent rectal carcinoma with survival rates of 22–42%. The Swansea Pelvic Oncology Group was established in 1999 and is involved in the assessment and management of advanced pelvic malignancies referred both regionally and UK wide. This paper will set out the selection, assessment, preparation, surgery, and outcomes from pelvic exenterative surgery for locally advanced primary rectal carcinomas.