Cystoprostatectomy versus prostatectomy alone for locally advanced or recurrent pelvic cancer

Turner, Greg A., Harris, Craig A., Eglinton, Tim W., Wakeman, Chris J., Kueppers, Frank, Dixon, Liane, Dobbs, Bruce R. and Frizelle, Frank A. (2016) Cystoprostatectomy versus prostatectomy alone for locally advanced or recurrent pelvic cancer. ANZ Journal of Surgery, 86 1-2: 54-58. doi:10.1111/ans.12808


Author Turner, Greg A.
Harris, Craig A.
Eglinton, Tim W.
Wakeman, Chris J.
Kueppers, Frank
Dixon, Liane
Dobbs, Bruce R.
Frizelle, Frank A.
Title Cystoprostatectomy versus prostatectomy alone for locally advanced or recurrent pelvic cancer
Journal name ANZ Journal of Surgery   Check publisher's open access policy
ISSN 1445-1433
1445-2197
Publication date 2016-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/ans.12808
Volume 86
Issue 1-2
Start page 54
End page 58
Total pages 5
Place of publication Richmond, VIC Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2017
Language eng
Formatted abstract
Background
There is minimal published data evaluating the oncological outcome of rectal resection with prostatectomy alone versus rectal resection with cystoprostatectomy in patients undergoing pelvic exenteration for locally advanced or recurrent pelvic cancer. This study aims to evaluate the oncological and functional outcomes of performing rectal resection with prostatectomy alone compared with rectal resection with cystoprostatectomy in patients undergoing pelvic exenteration.

Methods
Consecutive patients undergoing pelvic exenteration for locally advanced or recurrent pelvic cancer between 1998 and 2012 were identified from a prospectively maintained database. Patients undergoing rectal resection with prostatectomy alone were compared with a control group who underwent rectal resection with cystoprostatectomy and urostomy formation. The primary outcome was overall survival. Secondary outcomes analysed in the prostatectomy group included completeness of resection, continence and erectile function.

Results
Eleven rectal resections with prostatectomy were compared with 20 rectal resections with cystoprostatectomy. R0 resection was achieved in 73 and 65% respectively. There was no difference in overall survival (P = 0.40). Urinary continence was achieved in 36% of prostatectomy alone patients, while 27% experienced mild incontinence. Erectile function was poor, with only one patient able to maintain normal erections.

Conclusion
In appropriately selected patients with invasive pelvic tumours, rectal resection with prostatectomy alone provides adequate oncological outcomes. The ability to achieve an R0 resection was not compromised and overall survival is comparable with cystoprostatectomy. Urinary function is reasonable in most patients, although sexual function is compromised in almost all.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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Created: Sat, 09 Jan 2016, 14:14:28 EST by Craig Harris on behalf of Surgery - Mater Hospital