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Related Experiment Videos

Pelvic exenteration for advanced malignancy in elderly patients.

R W Radwan1, M D Evans1, M Davies1

  • 1Swansea Pelvic Oncology Group, Abertawe Bro Morgannwg University Local Health Board, Swansea, UK.

The British Journal of Surgery
|December 15, 2015
PubMed
Summary

Pelvic exenteration offers long-term survival for elderly patients with advanced pelvic malignancies. This aggressive surgery, despite risks, should not be withheld solely based on advanced age.

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Area of Science:

  • Surgical Oncology
  • Geriatric Oncology
  • Pelvic Malignancies

Background:

  • Pelvic exenteration is a radical surgery for advanced pelvic cancers.
  • Elderly patients undergoing major surgery face higher risks of complications and mortality.
  • This study evaluates outcomes of pelvic exenteration in patients aged 70 and above.

Purpose of the Study:

  • To assess the safety and efficacy of pelvic exenteration in elderly patients (≥70 years).
  • To determine survival rates and postoperative morbidity in this specific patient subgroup.
  • To inform clinical decision-making regarding pelvic exenteration in older adults.

Main Methods:

  • Retrospective review of patients aged 70+ undergoing pelvic exenteration (1999-2014).
  • Included primary rectal, gynecological, and bladder tumors.

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  • Primary endpoint: 5-year overall survival; secondary: morbidity and 30-day mortality.

    • Main Results:

    • 94 patients (median age 76) with rectal (65), gynecological (20), and bladder (9) cancers were analyzed.
    • 34% experienced postoperative complications; 6% had 30-day mortality.
    • 5-year survival rates: 47% (rectal), 31% (gynecological), 22% (bladder); P=0.023.

    Conclusions:

    • Pelvic exenteration can achieve long-term survival in selected elderly patients.
    • Advanced age alone should not be a contraindication for this procedure.
    • Careful patient selection is crucial for optimizing outcomes in geriatric populations.