Morbidity After Pelvic Exenteration for Gynecological Malignancies: A Retrospective Multicentric Study of 230 Patients. Issue 1 (1st January 2014)

• Record Type: Journal Article
• Authors: Chiantera, Vito; Rossi, Martina; De Iaco, Pierandrea; Koehler, Christardt; Marnitz, Simone; Fagotti, Anna; Fanfani, Francesco; Parazzini, Fabio; Schiavina, Riccardo; Scambia, Giovanni; Schneider, Achim; Vercellino, Giuseppe Filiberto
• Is Part Of: International journal of gynecological cancer. Volume 24:Issue 1(2014)
• Page Start: 156
• Page End: 164
• Publication Date: 2014-01-01
• Subjects: Pelvic exenteration -- Morbidity -- Mortality -- Gynecological malignancies; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000011
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: Our study purpose was to evaluate morbidity and postoperative mortality in patients who underwent pelvic exenteration (PE) for primary or recurrent gynecological malignancies. Methods: We identified 230 patients who underwent PE, referred to the gynecological oncology units of 4 institutions: Charitè University in Berlin, Friedrich-Schiller University in Jena, S. Orsola-Malpighi University in Bologna, and Catholic University in Rome and in Campobasso. Results: The median age was 55 years. The tumor site was the cervix in 177 patients, the endometrium in 28 patients, the vulva in 16 patients, and the vagina in 9 patients. Sixty-eight anterior, 31 posterior, and 131 total PEs were performed in 116 women together with hysterectomy. A total of 82.6% of the patients required blood transfusion. The mean operative time was 446 (95–970) minutes, and the median hospitalization was 24 (7–210) days. We noted a major complication rate of 21.3% (n = 49). We registered 7 perioperative deaths (3%) calculated within 30 days. The operation was performed within clear margins in 166 patients (72.2%). The overall mortality rate depending on tumor site at the end of the study was 75% for vulvar cancer, 57.6% for cervical cancer, 55.6% for vaginal cancer, and 53.6% for endometrial cancer. Conclusions: Although an important effort for surgeons and for patients, PE remains a therapeutic option with an acceptable complication rate and postoperative mortality. A strict selection of patients is mandatory to reach adequate surgical and oncologic outcomes.