Is pelvic exenteration in the presence of liver metastases justified?

Abstract

The presence of liver metastases in association with pelvic recurrence has been considered for a long period of time as the sign of systemic neoplastic impregnation and therefore, these patients were considered as candidates for palliative chemotherapy. However, in the last decades attention was focused on identifying patients who could benefit from surgery in such cases. The aim of the current paper is to discuss about the indications and contraindications of associating extended pelvic resections and liver resections in order to maximize the benefits in terms of survival for patients with advanced stage or recurrent rectal cancer.