Pelvic exenteration: long-term oncological results in a series of 106 patients

Abstract

Introduction: The aim of this retrospective study is to present the oncological results obtained in a series of 106 patients who underwent a pelvic exenteration with curative intent.

Patients and methods: Between December 1980 and December 2008 pelvic exenteration was performed in a series of 106 patients, in 69 for gynecologic cancer, in 29 for colorectal cancer, in 6 for urological and in 2 for skin cancer. In only 21 patients it was the primary treatment, in 85 it was for persistent or recurrent tumor. The resection was macroscopically complete in all patients.

Results: Overall five-year and ten-year survival was 40% and 33% respectively, disease-free survival 41 and 37%. Survival was better for gynecological tumors than for the other tumors. After supralevatoric exenteration survival was 50% and 47% and better than after infralevatoric exenteration. Exenteration with extension beyond the classical plane of dissection resulted in a 5 year survival of 32%. The only significant difference found was according to the margin status. After R1 resection the median survival was 24 months and the 5-year survival only 9% whereas R0 resection resulted in a 5-year survival of 47% and a local recurrence rate of 13.5%. Fifteen patients died from an unrelated cause. Only 12% of the patients alive 5 years after the operation suffered from recurrent tumor and surgery cured half of them.

Conclusion: Pelvic exenteration in patients with advanced or recurrent pelvic cancer results in a long-term cure rate of about 50% if an R0 resection has been obtained.