Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review. Issue 8 (August 2015)

• Record Type: Journal Article
• Authors: Sardain, H.; Lavoue, V.; Redpath, M.; Bertheuil, N.; Foucher, F.; Levêque, J.
• Is Part Of: European journal of surgical oncology. Volume 41:Issue 8(2015:Aug.)
• Page Start: 975
• Page End: 985
• Publication Date: 2015-08
• Subjects: Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2015.03.235
• Languages: English
• ISSNs: 0748-7983

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Objective</title> <p id="abspara0010">Pelvic exenteration requires complete resection of the tumor with negative margins to be considered a curative surgery. The purpose of this review is to assess the optimal preoperative evaluation and surgical approach in patients with recurrent cervical cancer to increase the chances of achieving a curative surgery with decreased morbidity and mortality in the era of concurrent chemoradiotherapy.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Review of English publications pertaining to cervical cancer within the last 25 years were included using PubMed and Cochrane Library searches.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Modern imaging (MRI and PET-CT) does not accurately identify local extension of microscopic disease and is inadequate for preoperative planning of extent of resection. Today, only half of pelvic exenteration procedures obtain uninvolved surgical margins.</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">Clear margins are required for curative pelvic exenterations, but are poorly predictable by pre-operative assessment. More extensive surgery, i.e. the infra-elevator exenteration with vulvectomy, is a logical surgical choice to increase the rate of clear margins and to improve patient survival following surgery for recurrent cervical carcinoma.</p> </sec> </abstract>