OBJECTIVE: To study the complication rate, local recurrence rate, and survival after total pelvic exenteration for primary advanced and recurrent @entity5 . DESIGN: Prospective study. SETTING: Tertiary referral university hospital, Norway. SUBJECTS: 25 @entity1 who were operated on for primary advanced and 22 for recurrent @entity5 since 1991; 42 @entity1 and 5 @entity1 , mean age 64 years (range 44-78). All had preoperative irradiation of 46-50 Gy. MAIN OUTCOME MEASURES: Incidence of major complications, and actuarial 5-year survival and local recurrence rate. RESULTS: Twenty @entity1 had RO resection in the primary group versus seven in the recurrent group. No R2 resections were done in the primary group compared with four in the recurrent group. Half the primary cases (n = 13) had abdominoperineal resections. Hartmann's procedures were common in both groups (n = 8 in each). Postoperative mortality at 30 days was 4% (n = 2) and in-hospital 13% (n = 6). 18 @entity1 had major complications and 12 were reoperated on. Overall 5-year actuarial survival for 43 @entity1 without distant metastases was 28%-those with primary @entity5 36%, and those with recurrent @entity5 18%-similar to the figures for @entity4960 resections. Actuarial local recurrence at 5 years for primary @entity5 was 18% compared with 68% for recurrent @entity5 , again nearly identical to the figures for R0/R1 operations (p = 0.008 and p = 0.03). CONCLUSION: Some @entity1 with advanced @entity5 either primary or recurrent may benefit from simultaneous en-bloc cystectomy. The higher postoperative morbidity and mortality indicate the need for well-defined indications for this procedure and the necessity for thorough preoperative staging.

Total pelvic exenteration with preoperative irradiation for advanced primary and recurrent XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'tumours', 'rectal cancer'] @entity1 :: ('9606', 'Species') :: ['women', 'patients', 'men'] @entity4960 :: ('910', 'Gene') :: ['RO and R1']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
