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Related Experiment Video

Updated: Jul 9, 2026

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Oncovascular Resection in Pelvic Exenteration: A Systematic Review.

Joshua Richard Burke1,2,3, Yasmin Oskui1, Imogen Samuel1

  • 1Colorectal & Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, UK.

ANZ Journal of Surgery
|July 7, 2026
PubMed
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Oncovascular pelvic exenteration achieved R0 resection in approximately two-thirds of patients, with a 1.9% 30-day mortality rate. Further research and improved patient selection are needed to enhance outcomes in this pioneering surgical field.

Area of Science:

  • Oncovascular surgery
  • Pelvic exenteration
  • Advanced pelvic malignancy

Background:

  • Resection of major vascular structures may be necessary for R0 resection in pelvic exenteration for advanced pelvic malignancy.
  • Limited evidence exists for pelvic oncovascular techniques and patient outcomes are not widely reported.

Purpose of the Study:

  • To systematically review the current literature on R0 resection rates and 30-day mortality following oncovascular pelvic exenteration.

Main Methods:

  • A systematic review of MEDLINE, EMBASE, Cochrane Library, and Web of Science was conducted.
  • Studies on oncovascular resection in advanced pelvic malignancy were included; pre-1980 studies were excluded from quantitative synthesis.
  • Data on R0 resection, postoperative morbidity, and mortality were extracted and bias was assessed using the ROBINS-1 V2 tool.

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Main Results:

  • Seventeen studies met inclusion criteria, with 411 patients in quantitative analysis.
  • The R0 resection rate was 65.3% among curative-intent procedures (n=334).
  • Thirty-day mortality was 1.9% (8/411), with overall survival of 41 months and disease-free survival of 27 months.

Conclusions:

  • Oncovascular pelvic exenteration achieves R0 resection in approximately two-thirds of patients, with 1.9% 30-day mortality.
  • Outcomes are currently inferior to conventional exenteration, indicating the pioneering phase of this practice.
  • Future efforts should focus on centralization, rigorous audit, benchmarking, and improved patient selection to enhance R0 and complication rates.