Surgical Management of Pelvic Malignancy: Role of Extended Abdominoperineal Resection/Exenteration/Abdominal Sacral Resection

Salvage of pelvic recurrence of colorectal cancer

“…The incidence of wound complications has decreased since we began using full thickness myocutaneous flaps for closure of the sacral wound. Among 58 patients with long-term follow-up as of April 2002, median OS was 32 months, with 5-year OS of 31%; and median disease-free survival (DFS) was 18 months, with 5-year DFS of 20% [73]. Type of primary resection (but not tumor stage) and CEA level were significant prognostic factors in our series.…”

“…This is accomplished by ABSR [12][13][14][15][16][17][18][19][20][21][22][23][68][69][70][71][72][73]92]. Thus, prior to making any decision about operative approach, the potential for sacral involvement must be evaluated.…”

“…We perform the procedure in two stages, 48 hr apart, with intervening stabilization in the intensive care unit. The steps of the procedure have been described in detail in previous publications [22,23,73], and are summarized here (Figs. 1-14).…”

“…A review of our own experience as of 2002 has been previously presented [73]. Of 177 patients referred Journal of Surgical Oncology 9.…”

“…Forty-four patients (76%) experienced recurrence after ABSR, with more than half developing distant disease (23 patients, 52.3%). Twelve patients (27.3%) developed local recurrence, and nine patients (20.4%) had both local and distant recurrence [73].…”