Pelvic Exenteration with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS + HIPEC) for Rectal Cancer—Case Series with Review of Literature
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Incidence of synchronous peritoneal metastases (PM) in colorectal cancer is approximately 5%, with another 5% of the patients develop metachronous PM. Colorectal PM has been hypothesized to be a loco-regional disease rather than a systemic spread, and cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has been considered as a viable treatment option. Pelvic exenteration is an established treatment option for locally advanced rectal cancer, but it is associated with significant morbidity. However, there are no studies evaluating the role of such procedure probably because the majority consider it as an exclusion criterion. Here, we present our experience with three cases of locally advanced rectal cancer with PM, treated successfully with pelvic exenteration and CRS-HIPEC.
KeywordsCRS HIPEC Pelvic exenteration Rectal cancer
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
For this type of study (retrospective), formal consent is not required.
Exenterative surgery along with CRS + HIPEC is not performed routinely, due to advances in understanding of disease biology, perioperative care, and more effective systemic therapy; more aggressive surgeries are being offered to improve the outcomes of patients with advanced disease, which were considered non-curable previously. This is the first series describing exenteration with CRS + HIPEC from the Indian subcontinent.
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