Imperial College London
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Professor Jamie Murphy BChir PhD FRCS FASCRS - Consultant Colorectal Surgeon

Faculty of Medicine, Department of Surgery & Cancer

Visiting Professor
 
 
 
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Contact

 

jamie.murphy

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Sasikumar:2017:10.1097/DCR.0000000000000737,
author = {Sasikumar, A and Bhan, C and Jenkins, JT and Antoniou, A and Murphy, J},
doi = {10.1097/DCR.0000000000000737},
journal = {Diseases of the Colon & Rectum},
pages = {346--352},
title = {Systematic review of pelvic exenteration with en bloc sacrectomy for recurrent rectal adenocarcinoma – R0 resection predicts disease free survival},
url = {http://dx.doi.org/10.1097/DCR.0000000000000737},
volume = {60},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: The management of recurrent rectal cancer is challenging. At the present time pelvic exenteration with en bloc sacrectomy offers the only hope of lasting cure. Objective: The purpose of this study was to evaluate clinical outcome measures and complication rates following sacrectomy for recurrent rectal cancer.Data Sources: Search conducted on ‘Pub Med’ for English language articles relevant to sacrectomy for recurrent rectal cancer with no time limitations.Study Selection: Studies reported sacrectomy with survival data for recurrent rectal adenocarcinoma. Main outcome measure: Disease free survival following sacrectomy for recurrent rectal cancer. Results: A total of 220 recurrent rectal cancer patients were included from 7 studies, of which 160 were male and 60 were female. Overall median operative time was 717 (570-992) minutes and blood loss was 3.7 (1.7-6.2) litres. An R0 (>1mm resection margin) resection was achieved in 78% of patients. Disease free survival associated with R0 resection was 55% at a median follow up period of 33 (17-60) months; however, none of the patients with R1 (<1mm resection margin) survived this period. Postoperative complication rates and median length of stay were found to decrease with more distal sacral transection levels. In contrast, R1 resection rates increased with more distal transection.Limitation: The studies assessed by this review were retrospective case series and thus are subject to significant bias. Conclusion: Sacrectomy performed for patients with recurrent rectal cancer is associated with significant postoperative morbidity. Morbidity and post-operative length of stay increase with the level of sacral transection.  Nevertheless, approximately half of patients eligible for rectal excision with en bloc sacrectomy may benefit from disease free survival for up to 33 months, with R0 resection predicting disease free survival in the medium term.
AU  - Sasikumar,A
AU  - Bhan,C
AU  - Jenkins,JT
AU  - Antoniou,A
AU  - Murphy,J
DO  - 10.1097/DCR.0000000000000737
EP  - 352
PY  - 2017///
SN  - 1530-0358
SP  - 346
TI  - Systematic review of pelvic exenteration with en bloc sacrectomy for recurrent rectal adenocarcinoma – R0 resection predicts disease free survival
T2  - Diseases of the Colon & Rectum
UR  - http://dx.doi.org/10.1097/DCR.0000000000000737
UR  - http://hdl.handle.net/10044/1/38765
VL  - 60
ER  -
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