Article Text
Abstract
Objectives The objective of this descriptive study was to determine free time to relapse after pelvic exenteration and reported surgical complication.
Methods A retrospective review of all women who underwent pelvic exenteration at Hospital Italiano de Buenos Aires between January 2008 and February 2018 was performed. Free time was defined as time from the date of exenteration to date of relapse.
Results Twenty five patients underwent pelvic exenteration for recurrent gynecologic cancers including cervical (n=18), vaginal (n=4), uterine (n=2),vulvar (n=1). Median age was 51 years (range 28–69).All patients had received prior treatment: surgery (n=14) or chemo radiotherapy (n=11). Thirteen patients underwent total pelvic exenteration (52%), eight patients anterior (32%) and one posterior pelvic exenteration. Three patients was performed radical hystercetomy. Urinary diversions technique consisted of ileal conduits (n=20) or ureterostomy (n=1). Permanent colostomy (n=6) or ileostomy (n=7) was performed in total o posterior exenteration. According to Clavien-Dindo Classification postoperative complications were related in 50% of the cases. Median time from primary treatment to exenteration was 10 months (15–30). Median follow up time was 29 months (12–41). At the time of analysis, 9 patients had recurred (36%). Median free time from the date of exenteration to date of relapse or death was 7 months (4–27). Two-year recurrence free survival was 71%.
Conclusions Despite the high morbidity and mortality rates, pelvic exenteration could be the only curative options for patients with pelvic recurrent gynecologic cancers.