Total pelvic exenteration as a therapeutic option in advanced malignant disease of the pelvis

Between 1966 and 1986, 99 patients underwent total pelvic exenteration at the Ellis Fischel State Cancer Center. Fifty-eight per cent of these were done for recurrence of carcinoma of the cervix uteri after radiation. The second most common type of malignant condition treated with total pelvic exenteration was localized advanced adenocarcinoma of the rectum. Fourteen of 99 patients died prior to discharge and after five years, 36 of 80 patients had survived. Seven deaths after discharge were attributed to the operation. There were 97 complications in 64 of the 99 patients after total pelvic exenteration prior to discharge. Between 1976 and 1981, one out of 14 patients undergoing total pelvic exenteration for locally advanced recurrent carcinoma of the cervix uteri died prior to discharge. Eight of 13 of the patients who survived that operation lived for five years. Total pelvic exenteration should be strongly considered in selected patients with locally advanced malignant lesions of the pelvis.