[Current status and outcomes of pelvic exenteration for recurrent cervical cancer: a systematic review]

To evaluate the current status and outcomes of pelvic exenteration (PE) for recurrent cervical cancer.

The following electronic databases has been searched on recurrent cervical cancer management and treatment:Chinese Biological Medicine Disk (CBM), PubMed and Cochrane library. All retrieved studies had to fulfill the following inclusion criteria: cohort studies of recurrent cervical cancer, containing information of detailed patient and operation characteristics as well as the survival rate. Only publications in the English literature were included. All eligible literatures between Jan. 1990 and Aug. 2013 were assessed for quality. Relevant basic characteristics, complications, survival rate and prognostic factors were reviewed.

There were eight trials involving 607 patients with cervical cancer received PE, including 515 cases with recurrent disease and 92 cases with primary disease. Four hundred and ninety patients had received total pelvic exenteration (TPE) operation, 103 underwent anterior pelvic exenteration (APE) and 14 received posterior pelvic exenteration (PPE). The 5-year overall survival rate for recurrent cervical cancer fluctuate from 26.7% to 56.0%. Complication rates were from 34.3% to 83.3% and the mortality rate was 1.2% (7/607). Among the relevant factors affecting survival time, resection margin status seemed to be the most important.

Based on this systematic review, PE does help improve the survival of recurrent cervical cancer patients on the basis of strict selection of candidates.