Pelvic exenterations for primary rectal cancer: Analysis from a 10-year national prospective database

Table 1 Demographic, preoperative, and surgical details for 82 pelvic exenterations n (%)

Variable	Value
Age, yr	61.8 (11.5)
Gender
Male	54 (65.9)
Female	28 (34.1)
ASA score
I	3 (3.7)
II	42 (51.2)
III	33 (40.2)
IV	4 (4.9)
Obstruction	5 (6.1)
MR T
T3	13 (15.9)
T4	56 (68.3)
Missing	13 (15.9)
MR N
N0	11 (13.4)
N1	24 (29.3)
N2	35 (42.7)
Missing	12 (14.6)
Sphincters involved	22 (26.8)
Metastasis at presentation	7 (8.5)
Neoadjuvant treatment	59 (72)
Long course RT	3 (5)
Long course CRT	41 (69.5)
CxT	4 (6.8)
Short Course RT	4 (6.8)
CxT followed by RT	7 (11.9)
Adjuvant treatment	54 (65.9)
CRT	6 (11.1)
CT	48 (88.9)
Perioperative transfusions, n	3.4 (2)
Anastomosis	15 (18.3)
Synchronous metastasis resected	4 (6.8)

Data are expressed as number of patients (%) or median (25-75 percentiles). ASA: American Society of Anaesthesiologists; CRT: Chemoradiation therapy; CxT: Chemotherapy; MR: Magnetic resonance; RT: Radiotherapy.

Table 2 Short-term outcomes n (%)

Variable	Value
Complications, any	45 (54.9)
Reoperation	8 (9.8)
Perioperative death	2 (2.4)
Sepsis	4 (4.9)
Abdominal Surgical Site Infection	15 (18.3)
Abdominal hernia	2 (2.4)
Perineal Wound Complications	13/67 (19.4)
Intra-abdominal septic complications	8 (9.8)
Injury to hollow viscera	2 (2.4)
Ileus	9 (11)
Urinary tract complications	9 (11)
Pulmonary complications	8 (9.8)
Neurological complications	2 (2.4)
Multiorgan failure	2 (2.4)
CVC infection	2 (2.4)
Acute kidney failure	2 (2.4)

Data are expressed as number of patients (%) or median (25-75 percentiles). CVC: Central venous catheter.

Table 3 Pathological outcomes and survival n (%)

Variable	Value
pT
Tx	2 (2.4)
T0	1 (1.2)
T2	2 (2.4)
T3a,b	6 (7.3)
T3c,d	13 (15.9)
T4a	27 (32.9)
T4b	30 (36.6)
Missing	1 (1.2)
pN
Nx	25 (30.5)
N0	33 (40.2)
N1	17 (20.7)
N2	6 (7.3)
Missing	1 (1.2)
Nodes isolated	15.5 (10.6)
Positive nodes	1.1 (0.4)
Resection margins involved	19 (23.2)
Response to neoadjuvant treatment (n = 59)
Complete	1 (1.7)
Islands of tumour cells	1 (1.7)
Predominantly fibrotic	20 (33.9)
Predominantly tumour nests	21 (35.6)
No response	12 (20.3)
Missing	4 (6.8)
Quality of mesorectum[20-23]
Good/complete	61 (74.4)
Partially good/near complete	9 (11)
Bad/incomplete	8 (9.8)
Missing	4 (4.9)

Data are expressed as number of patients (%) or median (25-75 percentiles).

Table 4 Propensity-matched analysis n (%)

	Pelvic exenteration n = 26	Non-exenterative total mesorectal excision n = 25	P value
Male	18 (58.1)	13 (52)	0.208
Age at surgery	63.1 ± 8.6	62.3 ± 13.7	0.794
ASA score			0.957
I	1 (3.8)	1 (4)
II	11 (42.3)	11 (44)
III	12 (46.2)	12 (48)
IV	2 (7.7)	1 (4)
Obstruction	1 (3.8)	0	0.322
Neoadjuvant treatment	21 (80.8)	21 (84)	0.762
Adjuvant treatment	19 (73.1)	21 (84)	0.343
Anastomosis	1 (3.8)	20 (80)	< 0.001a
T Stage			0.913
pT3a,b	1 (3.8)	1 (4)
pT3c,d	6 (23.1)	6 (24)
pT4a	7 (26.9)	7 (28)
pT4b	11 (42.3)	11 (44)
pTx	1 (3.8)	0
Resection margins involved	5 (19)	7 (28)	0.426
Perforation	2 (7.7)	4 (16)	0.357
Transfusions	2.6 ± 2.4	1.12 ± 2.4	0.035a
Quality of the mesorectum[20-23]			0.351
Good/Complete	16 (69.6)	13 (52)
Partially good/Nearly complete	4 (17.4)	8 (32)
Bad/Incomplete	3 (13)	4 (16)

^aP: statistically significant. ASA: American Society of Anaesthesiologists.