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Total pelvic exenteration. A 50-year experience at the Ellis Fischel Cancer Center
M J Lopez1, S B Standiford, J L Skibba
1Department of Surgery, St Elizabeth's Medical Center of Boston, Tufts University School of Medicine, Mass.
Objective:
To review a 50-year experience with total pelvic exenteration for treatment of advanced pelvic cancer.
Design:
Retrospective study with 100% follow-up.
Setting:
Cancer hospital.
Patients:
Two hundred thirty-two patients referred for treatment of advanced pelvic cancer who underwent total pelvic exenteration.
Main Outcome Measures:
Rates of operative mortality, complications, recurrence, and 5-year survival.
Results:
The morbidity rate was 45%. The operative death rate was 14% during the 50-year period, but decreased from 16.8% in the first three decades to 10% thereafter. Eighty-nine patients (38%) had recurrences. The overall 5-year survival rate was 42%.
Conclusions:
Operative mortality and morbidity have declined over 50 years, largely because of proper patient selection, increasing experience, and advances in perioperative care. Exenteration has a major role in the treatment of advanced pelvic cancer.