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Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer

INTRODUCTION: An infiltration of urological organs is found in 5–10% of patients with colorectal carcinoma. Total pelvic exenteration is the standard procedure for locally advanced rectal cancer. In selected patients with rectal cancer involving the prostate or seminal vesicles, the bladder can be p...

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Autores principales: Fernández-Martínez, Daniel, Rodríguez-Infante, Antonio, Castelo-Álvarez, Elsa, Fernández-Vega, Iván, Suárez-Hevia, Miguel, Truán-Alonso, Nuria, Baldonedo-Cernuda, Ricardo F., Álvarez-Pérez, José A., Sánchez-Farpón, Herminio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4201019/
https://www.ncbi.nlm.nih.gov/pubmed/25105771
http://dx.doi.org/10.1016/j.ijscr.2014.05.014
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author Fernández-Martínez, Daniel
Rodríguez-Infante, Antonio
Castelo-Álvarez, Elsa
Fernández-Vega, Iván
Suárez-Hevia, Miguel
Truán-Alonso, Nuria
Baldonedo-Cernuda, Ricardo F.
Álvarez-Pérez, José A.
Sánchez-Farpón, Herminio
author_facet Fernández-Martínez, Daniel
Rodríguez-Infante, Antonio
Castelo-Álvarez, Elsa
Fernández-Vega, Iván
Suárez-Hevia, Miguel
Truán-Alonso, Nuria
Baldonedo-Cernuda, Ricardo F.
Álvarez-Pérez, José A.
Sánchez-Farpón, Herminio
author_sort Fernández-Martínez, Daniel
collection PubMed
description INTRODUCTION: An infiltration of urological organs is found in 5–10% of patients with colorectal carcinoma. Total pelvic exenteration is the standard procedure for locally advanced rectal cancer. In selected patients with rectal cancer involving the prostate or seminal vesicles, the bladder can be preserved and en bloc radical prostatectomy with abdominoperineal rectal resection can be performed. We report two patients who treated with this combined approach. PRESENTATION OF CASE: Two patients with symptoms of rectal bleeding and pelvic pain were investigated. Colonoscopy demonstrated a tumor in the lower rectum. Biopsies revealed adenocarcinoma. Both pelvic MRI and endorectal ultrasound showed tumors that invaded the prostate and the seminal vesicles directly but without invasion of the bladder. After neoadjuvant chemoradiation, combined radical prostatectomy and abdominoperineal amputation was performed. None has developed local recurrence, but one of them was operated on for a single lung metastasis. After a follow-up of 28 and 20 months, respectively, the patients are alive without evidence of local recurrence or distant disease. DISCUSSION: This procedure obviates the need for urinary diversion without compromising the local tumor control. Intraoperative and postoperative diagnostic difficulties, and clinical aspects in relation to postoperative anastomotic leak and survival of patients are discussed. CONCLUSION: En bloc radical prostatectomy and proctosigmoidectomy is feasible in selected patients with rectal cancer and invasion limited to the prostate or seminal vesicles because it provides good local tumor control and significantly improves the patient's quality of life in comparison to total pelvic exenteration.
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spelling pubmed-42010192014-10-21 Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer Fernández-Martínez, Daniel Rodríguez-Infante, Antonio Castelo-Álvarez, Elsa Fernández-Vega, Iván Suárez-Hevia, Miguel Truán-Alonso, Nuria Baldonedo-Cernuda, Ricardo F. Álvarez-Pérez, José A. Sánchez-Farpón, Herminio Int J Surg Case Rep Article INTRODUCTION: An infiltration of urological organs is found in 5–10% of patients with colorectal carcinoma. Total pelvic exenteration is the standard procedure for locally advanced rectal cancer. In selected patients with rectal cancer involving the prostate or seminal vesicles, the bladder can be preserved and en bloc radical prostatectomy with abdominoperineal rectal resection can be performed. We report two patients who treated with this combined approach. PRESENTATION OF CASE: Two patients with symptoms of rectal bleeding and pelvic pain were investigated. Colonoscopy demonstrated a tumor in the lower rectum. Biopsies revealed adenocarcinoma. Both pelvic MRI and endorectal ultrasound showed tumors that invaded the prostate and the seminal vesicles directly but without invasion of the bladder. After neoadjuvant chemoradiation, combined radical prostatectomy and abdominoperineal amputation was performed. None has developed local recurrence, but one of them was operated on for a single lung metastasis. After a follow-up of 28 and 20 months, respectively, the patients are alive without evidence of local recurrence or distant disease. DISCUSSION: This procedure obviates the need for urinary diversion without compromising the local tumor control. Intraoperative and postoperative diagnostic difficulties, and clinical aspects in relation to postoperative anastomotic leak and survival of patients are discussed. CONCLUSION: En bloc radical prostatectomy and proctosigmoidectomy is feasible in selected patients with rectal cancer and invasion limited to the prostate or seminal vesicles because it provides good local tumor control and significantly improves the patient's quality of life in comparison to total pelvic exenteration. Elsevier 2014-06-05 /pmc/articles/PMC4201019/ /pubmed/25105771 http://dx.doi.org/10.1016/j.ijscr.2014.05.014 Text en © 2014 The Authors http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Article
Fernández-Martínez, Daniel
Rodríguez-Infante, Antonio
Castelo-Álvarez, Elsa
Fernández-Vega, Iván
Suárez-Hevia, Miguel
Truán-Alonso, Nuria
Baldonedo-Cernuda, Ricardo F.
Álvarez-Pérez, José A.
Sánchez-Farpón, Herminio
Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer
title Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer
title_full Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer
title_fullStr Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer
title_full_unstemmed Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer
title_short Combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer
title_sort combined radical prostatectomy and abdominoperineal resection for locally invasive rectal cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4201019/
https://www.ncbi.nlm.nih.gov/pubmed/25105771
http://dx.doi.org/10.1016/j.ijscr.2014.05.014
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