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A modern-day experience with Brunschwig's operation: Outcomes associated with pelvic exenteration
Eric Rios-Doria1, Olga T Filippova1, Alli M Straubhar1
1Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Gynecologic Oncology
|September 5, 2022
Summary
Pelvic exenteration for gynecologic cancers has a high complication rate but low perioperative mortality. Survival rates after this major surgery are moderate, highlighting the need for advanced care.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Oncologic Outcomes
Background:
- Pelvic exenteration is a radical surgical procedure for advanced gynecologic malignancies.
- Evaluating outcomes is crucial for patient selection and management.
Purpose of the Study:
- To assess postoperative complications and oncologic outcomes of pelvic exenteration.
- To identify factors associated with outcomes in non-ovarian gynecologic cancers.
Main Methods:
- Retrospective review of 100 patients undergoing pelvic exenteration (2010-2019).
- Analysis of early (≤30 days) and late (31-180 days) complications graded by severity.
- Kaplan-Meier method for survival analysis, excluding palliative cases.
Main Results:
- High complication rate (97%) with 50% experiencing major complications (grade ≥ 3).
- No deaths within 30 days; 6 late deaths. Three-year progression-free survival was 61.0%, overall survival 61.6%.
- No variables were statistically associated with complication development.
Conclusions:
- Pelvic exenteration is associated with a high overall complication rate.
- Improved perioperative care contributes to low perioperative mortality.
- Survival outcomes demonstrate the complex balance of morbidity and oncologic benefit.
