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Palliative exenteration--what, when, and why?

C R Stanhope, R E Symmonds

    American Journal of Obstetrics and Gynecology
    |May 1, 1985
    PubMed
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    Pelvic exenteration, a surgical procedure, can offer palliative benefits for advanced cancers. Survival rates in patients receiving palliative pelvic exenteration were comparable to those for aggressive surgical management in advanced ovarian cancer.

    Area of Science:

    • Oncology
    • Surgical Oncology
    • Gynecologic Oncology

    Background:

    • Pelvic exenteration is a radical surgical procedure for advanced pelvic malignancies.
    • Historically, it is performed with curative intent, but palliative applications are also considered.

    Purpose of the Study:

    • To evaluate the palliative benefits and survival outcomes of pelvic exenteration in patients with advanced pelvic cancer.
    • To compare these outcomes with aggressive surgical management in advanced epithelial ovarian carcinoma.

    Main Methods:

    • Retrospective analysis of 323 pelvic exenterations performed between 1955 and 1981.
    • Identification of 59 (18%) palliative cases based on metastatic disease (nodal, peritoneal, bone, distant).
    • Survival analysis stratified by metastatic disease and prior pelvic recurrence.

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    Main Results:

    • Overall survival for palliative pelvic exenteration was 47% at 2 years and 17% at 5 years.
    • For patients with metastatic nodal disease after irradiated pelvic recurrence, 2-year survival was 46% and 5-year survival was 23%.
    • These survival rates suggest significant palliative benefit.

    Conclusions:

    • Palliative pelvic exenteration provides worthwhile benefits for selected patients with advanced pelvic malignancies.
    • Outcomes are comparable to aggressive surgical management advocated for advanced epithelial ovarian carcinoma.
    • This supports the consideration of palliative exenteration in advanced cancer cases where curative options are exhausted.