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Overall survival after pelvic exenteration for gynecologic malignancy
Shannon N Westin1, Vijayashri Rallapalli1, Bryan Fellman2
1Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Gynecologic Oncology
|July 12, 2014
Summary
Five-year survival after pelvic exenteration for gynecologic cancers is 40%. Positive lymph nodes and lymphovascular space invasion are key factors impacting outcomes, highlighting the need for careful patient selection and surgical planning.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Survival Analysis
Background:
- Pelvic exenteration is a radical surgical procedure for advanced gynecologic malignancies.
- Previous reports indicate a 5-year survival rate as high as 60%.
Purpose of the Study:
- To determine the overall survival (OS) after pelvic exenteration for gynecologic malignancies.
- To identify clinical and pathological factors influencing survival outcomes.
Main Methods:
- Retrospective review of 160 patients undergoing pelvic exenteration (February 1993 - December 2010).
- Survival analysis using Kaplan-Meier method and multivariate analysis.
- Evaluation of factors including treatment-free interval, primary site, margin status, lymphovascular space invasion (LVSI), lymph node status, and perineural invasion.
Main Results:
- Five-year recurrence-free survival (RFS) was 33%.
- Factors negatively impacting RFS included positive margins, LVSI, and positive lymph nodes.
- Five-year overall survival (OS) was 40%.
- Positive lymph nodes and LVSI were significant independent predictors of poor OS.
Conclusions:
- The 5-year OS after pelvic exenteration for gynecologic malignancy is 40%.
- Survival outcomes have not significantly improved, underscoring the importance of patient selection.
- Non-modifiable factors present at the time of surgery significantly influence survival.
