Outcomes of pelvic exenteration for locally advanced primary rectal cancer: Overall survival and quality of life.
INTRODUCTION
Radical surgery with pelvic exenteration offers the only potential for cure in patients with locally advanced primary rectal cancer. This study describes the clinical and patient-reported quality of life outcomes over 12 months for patients having pelvic exenteration for locally advanced primary rectal cancer at a specialised centre for pelvic exenteration.


METHODS
Clinical data of consecutive patients undergoing pelvic exenteration for locally advanced primary rectal cancer and patient-reported outcomes were collected at baseline, hospital discharge and at 1, 3, 6, 9 and 12 months. Patient-reported outcomes included cancer-specific quality of life (QoL) and physical and mental health status. Quality of life trajectories were modelled over the 12 months from the date of surgery using linear mixed models.


RESULTS
104 patients with locally advanced rectal cancer underwent pelvic exenteration at Royal Prince Alfred Hospital, Sydney, between December 1994 and October 2014. Complete soft tissue exenteration was performed in 38%. A clear margin was obtained in 86% with a 62% overall five-year survival. QoL outcome questionnaires were completed by 62% of patient cohort. The average FACT-C score returned to pre-surgery QoL by 2 months after surgery, and the average QoL continued to increase slowly over the 12 months.


CONCLUSION
Our results support an aggressive approach to advanced primary rectal cancer and lend weight to the oncological role of pelvic exenteration for this group of patients. Quality of life improves rapidly after pelvic exenteration for locally advanced primary rectal cancer and continues to improve over the first year.
['Quyn|A J|AJ|', 'Austin|K K S|KK|', 'Young|J M|JM|', 'Badgery-Parker|T|T|', 'Masya|L M|LM|', 'Roberts|R|R|', 'Solomon|M J|MJ|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D005500:Follow-Up Studies D006801:Humans D053208:Kaplan-Meier Estimate D007902:Length of Stay D008297:Male D008875:Middle Aged D009517:New South Wales D010385:Pelvic Exenteration D011788:Quality of Life D012004:Rectal Neoplasms D057566:Self Report D016896:Treatment Outcome
Pelvic exenteration Rectal Cancer Quality of life