Management of stage IV rectal cancer: Palliative options

Table 1 Contraindications to resective operative intervention

Sciatic nerve pain

Bilateral ureteral obstruction

Extensive fixation to lateral pelvic side wall (CT/MRI or trial dissection)

Sacral involvement above S2 (resection produces spinal instability or post-operative complications)

Bilateral lymphedema or bilateral venous thrombosis (indicating encasement of major vascular structures)

Multiple peritoneal metastasis or metastasis fixed to or invading vital structures

CT: Computed tomography; MRI: Magnetic resonance imaging.