Pelvic exenteration for locally advanced primary and recurrent pelvic neoplasm: a series of 54 resectable cases

Abstract

Objective: To report on a series of 54 patients with pelvic neoplasms submitted to curative pelvic exenteration at a tertiary hospital and describe the results (morbidity, mortality, and long-term survival). Methods: The complete data of 54 patients submitted to pelvic exenteration between 1999 and 2007 were evaluated. Sixteen men and 38 women with a mean age of 65 years and median age of 66 years (36 to 77) were studied. Surgical procedures included total pelvic exenteration (n = 26), anterior pelvic exenteration(n = 5), and posterior pelvic exenteration (n = 23). Rresults: The mean operative time was 402 minutes (280 to 585). The average volume of intraoperative bleeding was 2,013 ml (300 to 5,800). Postoperative mortality was 5% (n = 3). The overall morbidity rate was 46%(n = 25). Histological evaluation demonstrated that 47 resections were R0 (87%) while seven were R1 (13%). The overall survival rate in five years was 23.5% (n = 12). Cconclusions: Despite its aggressive nature and high morbidity, pelvic exenteration is still justified in locally advanced pelvic neoplasms or even in isolated pelvic recurrence, since it affords a greater long-term control of the neoplasm.

Keywords

• Pelvic exenteration
• Rectal neoplasms
• Genital neoplasms
• female/mortality
• Morbidity