Introduction/Background Pelvic exenteration is a major surgical procedure for advanced or recurrent gynaecological cancer. It is a potentially curative treatment but it could also be performed with palliative intent.
Methodology All patients undergoing pelvic exenteration between December 2014 and April 2019 at the Swansea Gynaecological Oncology Centre were identified through our surgical database. Patient characteristics, the indications for the procedure, pathology results and outcomes were retrospectively analysed. We used frequencies and percentages to describe the sample. Mean values were calculated where appropriate. Statistical comparisons were conducted with chi-squared test and Analysis of Variance where appropriate. A p-value of <0.05 was considered statistically significant. Statistical analyses were performed with IBM SPSS 25.0 (SPSS Inc, Chicago, IL, USA).
Results 19 patients were identified who had pelvic exenteration for vulvar, vaginal and cervical cancer during the study period. The mean age of the women was 57.5 years (42–82 years). The vulva was the commonest primary site of malignancy. 11 women underwent posterior pelvic exenteration, 6 women underwent total pelvic exenteration and 2 women had anterior pelvic exenteration. 11 women had a form of radiotherapy or chemotherapy or both. 58% of the women were still alive at 1 year and 43% was still living at 2 years. Survival was not associated with margin status (p=0.074), lymphovascular space invasion (p=0.149) or pathological lymph node status (p=0.707). However, there was a strong association between adverse survival and perineural invasion (p=0.009).
Conclusion Although pelvic exenteration is a major procedure with high morbidity, it is a treatment option with favourable outcomes in some women with advanced gynaecological malignancies even when post-operative pathology reports might appear unfavourable.
Disclosure Nothing to disclose.
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