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Pelvic Exenteration in Gynecologic Cancer: La Paz University Hospital Experience
  1. Elisa Moreno-Palacios, MD,
  2. Maria D. Diestro, PhD, MD,
  3. Javier De Santiago, PhD, MD,
  4. Alicia Hernández, PhD, MD and
  5. Ignacio Zapardiel, PhD, MD
  1. Gynecologic Oncology Unit, La Paz University Hospital and Autonomous University of Madrid, Madrid, Spain.
  1. Address correspondence and reprint requests to Elisa Moreno-Palacios, MD, Gynecologic Oncology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain. E-mail: elimorepal{at}


Background Pelvic exenteration is an ultraradical surgery involving the en bloc resection of the pelvic organs, including the internal reproductive organs, the distal urinary tract (ureters, bladder, urethra), and/or anorectum. It is mainly applied as a salvage surgery for recurrent gynecologic tumors of any origin (vulva, vagina, cervix, uterine, and also ovary). Our aim was to establish the most favorable cases for this type of surgery by means of a review of our institution experience.

Methods Retrospective analyses of all patients treated with pelvic exenteration for recurrent gynecologic cancer from 2008 to 2014 at La Paz University Hospital.

Results Ten patients underwent pelvic exenteration for recurrent gynecologic cancers including uterine, cervical, vaginal, vulvar, and ovarian cancer. All patients had received prior treatment: surgery, radiotherapy, and/or chemotherapy. Eight patients underwent total pelvic exenteration, one anterior and one posterior pelvic exenteration. Urinary diversions technique consisted of ileal conduits in all cases. Permanent colostomy was performed in all cases. Postoperative complications were related to the urinary diversion in 50% of the cases, to the reconstructive technique in 30%, and to systemic or pelvic infections in 20%.

Conclusions Despite the high morbidity and mortality rates, pelvic exenteration is feasible, and in selected cases of cancer recurrence is the last possible treatment.

  • Gynecologic cancer
  • Pelvic exenteration
  • Reconstructive techniques
  • Recurrent cancer

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  • The authors declare no conflicts of interest.