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572 Long term treatment outcome after Pelvic exenterations for recurrent gynaecological cancers
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  1. PN Rema1,
  2. S Sambasivan1,
  3. A Nath2,
  4. S Ranjith J2 and
  5. A Mathew3
  1. 1Regional cancer center, Department of Gynaecologicaloncology, Thiruvananthapuram, India
  2. 2Regional cancer center, Department of surgical oncology, Thiruvananthapuram, India
  3. 3Regional cancer center, Department of Epidemiology and biostatistics, Thiruvananthapuram, India

Abstract

Introduction/Background*Pelvic exenteration is radical enbloc resection of pelvic organs followed by surgical reconstruction. This is considered a curative treatment in recurrent gynaecological cancers. The present study looked into the long term survival outcome and morbidities associated with pelvic exenterations done in our centre.

Methodology The study included patients who underwent pelvic exenteration for recurrent gynaecological cancers from January 2006 to December 2016. Patient characteristics, nature of disease, type of surgery, complications associated were retrieved from the medical records. Surgical complications were graded with Clavein dindo grading. Patients were followed up till December 2020.Survival analysis was done using Kaplan- Meir method

Result(s)*32 patients were included in the study. Cervical cancer was most common recurrent cancer (81.2%), 6.2% had vulvar cancer, 6.2% had vaginal cancer and 3.1% had endometrial cancer. There were 14 anterior exenterations, 17 total exenterations and 1 posterior exenteration. There was no immediate post-operative mortality. Post-operative complications were seen in 68.5% of which the majority were related to the urinary tract. One patient had Grade IV complication (post-operative myocardial infarction) 4 Grade IIIB (re-laparotomies), 7 patients had Grade II and 10 patients had Grade I complications. Median hospital stay was 12 days (Range 8-22days). Median overall survival was 41 months. 5 year as well as 7 year overall survival was 38%. Median disease free survival was 15 months.

Conclusion*This small series shows that pelvic exenterations are potentially curable surgeries in selected patients with recurrent gynaecological cancers with reasonable long term survival benefit and acceptable morbidity

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