Abstract: The genitourinary tract is known to be infiltrated in 3–10% of cases of advanced rectal adenocarcinoma. It is usually managed with total pelvic exenteration with urinary diversion. Complications are encountered because of this diversion. This case series aims to present four cases of locally advanced rectal adenocarcinoma involving the prostate who underwent en bloc prostatectomy in Jose Reyes Memorial Medical Center. Methods: This case series consists of review of records of hospital charts, documentation of specimens from the database of the department. Results: The study consists of four (4) male patients in their 50s presenting with primary rectal adenocarcinoma with invasion to the prostate, bladder or seminal vesicle. Two out of 4 patients had shorter hospital days (6 days) while 2 patients spent 14 and 28 days. Two out of 4 patients have anastomotic leakage, 1 had nosocomial pneumonia and no one had urinary tract infection, postoperatively. All 4 patients had a histopathologic diagnosis of rectal adenocarcinoma with a tumor size of 3.5 to 7.0 cm. Two patients are positive for lymphovascular space invasion while 1 patient has a positive line of resection margin. Two patients had neoadjuvant chemotherapy and radiotherapy while 1 patient had 1 adjuvant chemotherapy and radiotherapy. One patient was lost to follow-up. Conclusion En bloc prostatectomy combined with abdominoperineal resection to treat locally advanced rectal adenocarcinoma provides good local control with the risk of having less postoperative complications. Since there is only one stoma, there is less chance of infection and better quality of life. Complete resection of the tumor can be obtain but can also cause urologic morbidity even after chemotherapy and radiotherapy.
Proctectomy