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Pelvic exenteration with curative intent for recurrent uterine malignancies
Fady Khoury-Collado1, M Heather Einstein, Bernard H Bochner
1Department of Surgery, Gynecology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Gynecologic Oncology
|October 22, 2011
Summary
Pelvic exenteration offers long-term survival for select recurrent uterine cancer patients. However, this surgery has a high rate of significant postoperative complications that require careful patient discussion.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Oncologic Surgery
Background:
- Recurrent uterine malignancies present significant treatment challenges.
- Pelvic exenteration is a radical surgical option for advanced or recurrent pelvic cancers.
Purpose of the Study:
- To evaluate the outcomes of pelvic exenteration for recurrent uterine malignancies.
- To assess survival rates and postoperative complications in the modern era.
Main Methods:
- Retrospective review of 21 patients undergoing pelvic exenteration for recurrent uterine malignancies (1997-2011).
- Analysis of postoperative complications (graded) and survival using Kaplan-Meier method.
Main Results:
- The 5-year survival for the cohort was 40%, with improved rates for endometrioid tumors (50%) and sarcomas (66%).
- High rates of grade 3 complications (48%) and re-operations (24%) were observed within 90 days.
- Pelvic sidewall involvement and hydronephrosis did not negatively impact survival.
Conclusions:
- Pelvic exenteration can achieve long-term survival in carefully selected patients with recurrent uterine malignancies.
- Significant postoperative morbidity is a characteristic of this procedure and necessitates thorough patient counseling.
