Complications and survival after total pelvic exenteration.

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Pelvic exenteration is a complex surgical procedure associated with significant morbidity.
• Patient selection is crucial, yet major postoperative complications remain a concern.

Purpose of the Study:

• To investigate associations between perioperative markers and major postoperative complications.
• To evaluate the impact of these complications on patient survival following pelvic exenteration.

Main Methods:

• Retrospective analysis of 195 consecutive patients undergoing total pelvic exenteration.
• Data collected from January 2015 to February 2020 at a single tertiary university hospital.

Main Results:

• 30-day mortality was 0.5%; 34.5% experienced major complications (Clavien-Dindo ≥3).
• Low albumin and blood transfusion correlated with major complications (univariate).
• Positive margins, liver metastasis, and high Charlson Comorbidity Index (>6) predicted poor survival.

Conclusions:

• Major postoperative complications do not negatively impact overall survival after pelvic exenteration.
• Achieving negative margins makes pelvic exenteration a potentially life-prolonging surgery.
• Comorbidity significantly predicts inferior outcomes, highlighting its importance in patient management.