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Abstract
Introduction/Background Pelvic exenteration (PE) can be described as the most radical surgery performed in patients with recurrence or persistent gynecologic cancer.
The aim of this study was to evaluate morbidity and survival after PE, and to analyze if survival was modified with age, primary tumor or PE type.
Methodology Retrospective observational review of 82 patients with histological diagnosis of gynecologic malignant pelvic tumor (ovary, cervix, endometrium, vulva, vagina, and sarcoma), who underwent PE with curative intent at our center between 2000 and 2023.
Average survival (AS) was estimated by the method Kaplan-Meier. The significance level used was 5% (α =0.05) and the analysis was performed using SPSS(V29.0).
Results The average age at time of surgery was 62,5 years. Distribution of tumor site was: ovary (n=58), cervix (n=13), endometrium (n=6), sarcoma (n=2), vagina (n=2) and vulva (n=1). PE was anterior (n=6), posterior (n=62) and total (n=14).
The mean operative time was 321 minutes. Intraoperative complications were observed in 7 patients. Overall morbidity was 52,4%; 36 patients (43,9%) developed an early complication and 7 (8,5%) a late complication: 12 gastrointestinal, 6 urinary, 17 infectious and 10 abdominal wall complications. 25 cases required reoperation because of this.
With a median follow-up of 20 months, we observed a non-significant trend towards longer survival in patients who had anterior PE compared with patients who had posterior and total PE. In multivariable Cox-regression age was significantly associated with mortality.
Only one case of early postoperative mortality was recorded. The 5-year AS in remaining cases was 32%.
Conclusion The PE is still the only curative option with an acceptable survival, perioperative morbidity and rate of mortality, in recurrent or persistent gynecological malignancies, for selected patients, after chemoradiation and/or primary surgery failed.
Disclosures The authors have no conflicts of interest to declare.
