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Long‐term clinical outcome of pelvic exenteration in patients with advanced gynecological malignancies
Author(s) -
Fotopoulou Christina,
Neumann Ulf,
Kraetschell Robert,
Schefold Joerg C.,
Weidemann Henning,
Lichtenegger Werner,
Sehouli Jalid
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21518
Subject(s) - medicine , pelvic exenteration , surgery , ileus
Background and Objectives We evaluated the outcome of pelvic exenteration in women with locally advanced primary or recurrent gynecological malignancies. Methods All pelvic exenteration procedures performed between 01/2003 and 06/2009 were evaluated. Extent of surgical radicality, operative techniques, and outcome were evaluated. Kaplan–Meier curves were calculated for Overall (OS) and progression‐free survival (PFS). Results Forty‐seven patients (median age: 52.5 years) were evaluated. Ten of 47 patients (21.3%) had a primary and 37(78.7%) a relapsed cancer. Most common (80.8%) site of origin was the cervix. Patients (80.8%) had undergone previous pelvic irradiation. A total exenteration was performed in 32/47 patients (68%). A complete tumor resection was obtained in 23 patients (49%). Thirty‐three patients (70.2%) had at least one major complication, including ileus (8.5%), intestinal‐fistula (29.8%), ureteral anastomotic insufficiency (6.4%), abscess (6.4%), and cardiothrombotic events (23.4%). At a median follow‐up of 7 months (range: 1–42), 22/47 patients (46.8%) died and 22/47 (46.8%) experienced a relapse. Median OS was 4 months (range: 0.1–16) and 22 months (range: 6–42) for patients with versus without postoperative tumor residuals, respectively ( P = 0.0006), while median PFS was 4 months (range:0.1–16) versus 12months (range: 6–42) ( P < 0.0001). Conclusions Radical pelvic exenteration due to advanced pelvic malignancies may be associated with a high morbidity. Complete tumor resection is associated with a significantly higher overall and PFS. J. Surg. Oncol. 2010; 101:507–512. © 2010 Wiley‐Liss, Inc.