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Related Experiment Videos

Composite pelvic exenteration: is it worthwhile?

Marvin J Lopez1, Pedro Luna-Pérez

  • 1Department of Surgery, Division of Surgical Oncology, St. Elizabeth's Medical Center and Tufts University School of Medicine, Boston, MA 02135, USA. marvin_lopez_md@cchcs.org

Annals of Surgical Oncology
|December 31, 2003
PubMed
Summary
This summary is machine-generated.

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En bloc resection of pelvic organs with bony pelvis portions offers substantial survival for locally advanced pelvic cancers fixed to bone. While morbidity is high, operative mortality is low, indicating utility in select cases.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Pelvic Surgery

Background:

  • Locally advanced pelvic cancer with tumor fixation to the bony pelvis is often considered unresectable.
  • Limited data exist on the effectiveness of pelvic exenteration combined with en bloc resection of involved bone.

Purpose of the Study:

  • To evaluate the utility and outcomes of pelvic exenteration with en bloc resection of the bony pelvis for locally advanced pelvic cancers.
  • To assess survival rates, morbidity, and mortality associated with this complex surgical procedure.

Main Methods:

  • Retrospective analysis of 625 patients undergoing radical pelvic procedures, identifying 34 with en bloc resection of pelvic organs and bone.
  • Detailed patient demographics, primary tumor types (rectal, cervicouterine, anal, etc.), and extent of bony resection (sacrum, ischium, pubic symphysis, hemipelvectomy).

Related Experiment Videos

  • Preoperative pelvic irradiation was common; various types of pelvic exenterations were performed.

    • Main Results:

    • High surgical morbidity rate of 67.6% observed in the cohort.
    • Median follow-up of 37 months revealed significant cancer-related mortality (50%).
    • Five-year overall survival was 44%, and cancer-specific survival was 52%, with varied recurrence patterns.

    Conclusions:

    • Pelvic exenteration with en bloc bony resection can achieve substantial survival for patients with pelvic cancers fixed to limited portions of the bony pelvis.
    • The procedure is associated with significant morbidity but infrequent operative mortality.
    • This approach offers a viable, albeit complex, treatment option for select patients with advanced pelvic malignancies involving bone.