RT Journal Article
SR Electronic
T1 Morbidity After Pelvic Exenteration for Gynecological Malignancies: A Retrospective Multicentric Study of 230 Patients
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 156
OP 164
DO 10.1097/IGC.0000000000000011
VO 24
IS 1
A1 Chiantera, Vito
A1 Rossi, Martina
A1 De Iaco, Pierandrea
A1 Koehler, Christardt
A1 Marnitz, Simone
A1 Fagotti, Anna
A1 Fanfani, Francesco
A1 Parazzini, Fabio
A1 Schiavina, Riccardo
A1 Scambia, Giovanni
A1 Schneider, Achim
A1 Vercellino, Giuseppe Filiberto
YR 2014
UL http://ijgc.bmj.com/content/24/1/156.abstract
AB Objective Our study purpose was to evaluate morbidity and postoperative mortality in patients who underwent pelvic exenteration (PE) for primary or recurrent gynecological malignancies.Methods We identified 230 patients who underwent PE, referred to the gynecological oncology units of 4 institutions: Charitè University in Berlin, Friedrich-Schiller University in Jena, S. Orsola-Malpighi University in Bologna, and Catholic University in Rome and in Campobasso.Results The median age was 55 years. The tumor site was the cervix in 177 patients, the endometrium in 28 patients, the vulva in 16 patients, and the vagina in 9 patients. Sixty-eight anterior, 31 posterior, and 131 total PEs were performed in 116 women together with hysterectomy. A total of 82.6% of the patients required blood transfusion. The mean operative time was 446 (95–970) minutes, and the median hospitalization was 24 (7–210) days. We noted a major complication rate of 21.3% (n = 49). We registered 7 perioperative deaths (3%) calculated within 30 days. The operation was performed within clear margins in 166 patients (72.2%). The overall mortality rate depending on tumor site at the end of the study was 75% for vulvar cancer, 57.6% for cervical cancer, 55.6% for vaginal cancer, and 53.6% for endometrial cancer.Conclusions Although an important effort for surgeons and for patients, PE remains a therapeutic option with an acceptable complication rate and postoperative mortality. A strict selection of patients is mandatory to reach adequate surgical and oncologic outcomes.