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What is life like after pelvic exenteration? The longitudinal assessment of quality of life after pelvic exenteration for recurrent/persistent gynaecological cancer
  1. A Fernandes1,
  2. S Bryan1,
  3. D Kolomainen2,
  4. R Phipps3,
  5. K Power4,
  6. A Thompson5 and
  7. D Barton1
  1. 1Gynaecology, The Royal Marsden NHS Foundation Trust
  2. 2Gynaecology, Southend University Hospital NHS Foundation Trust
  3. 3The Royal Marsden NHS Foundation Trust
  4. 4Plastic Surgery
  5. 5Urology, The Royal Marsden NHS Foundation Trust, London, UK


Introduction/Background Pelvic exenteration (PE) can result in considerable acute and long-term morbidity. Routine longitudinal assessment of quality of life (QoL) of women with recurrent/persistent gynaecological cancer undergoing/had undergone PE, was implemented in 2012 to evaluate trends in QoL prospectively.

Methodology The European Organisation for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) was completed by women before and/or after PE attending out-patient consultations between 2012 and 2018. Data were collected at various time-points from baseline to up to12 years post-surgery. Descriptive analysis, frequencies and independent chi-square tests were performed.

Results Forty-two women underwent PE with curative intent, with a mean age of 58 years (SD 10.8) were included, 40 had received pelvic radiotherapy, and 60% had cervical or endometrial cancer. A total PE was performed in 52% (n=22) of women, anterior PE in 28% (N=12) and posterior PE in 20% (n=8). In 31% of total PE cases a double-barrelled stoma was formed.

Abstract – Figure 1

Global health status

Abstract – Figure 2

Functional scores

QoL at baseline was poor, further decreased at 1-month post-surgery, showed a steady improvement after 6 months, which continued long-term (>5 years) both in Global Health status and all functioning scores. With the exception of diarrhoea and insomnia, all symptoms significantly improved 1-month post-surgery. Pain scores halved from baseline to 1–2 years (43.5 to 20). In women with a total PE, those with a double-barrelled stoma had better emotional, social and cognitive functioning compared to those who had a colostomy and urostomy(e.g. x2(8, 68) =17.58 p<0.05).

Conclusion PE can improve the QoL of women with recurrent/persistent gynaecological cancer who are symptomatic. In cases of total PE, the double-barrelled stoma have better outcomes compared to two stomas. These findings will better inform women for whom PE is offered as a treatment option. They highlight the importance of continued interdisciplinary collaboration from the planning of surgery to long-term follow-up.

Disclosure Nothing to disclose.

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