Pelvic exenteration in gynecologic cancer

Pelvic exenteration in gynecologic cancer: morbidity and
survival in a referral cancer center
Gurgel, M.V.S.A.*, Andrade, C.E.M.C.*, Vieira, M.A.*, Reis, R.*, Cintra, G.F.*, Tsunoda, A.T.*
*Department of Gynecology Oncology from Barretos Cancer Hospital, São Paulo, Brazil
Pelvic exenteration in gynecologic cancer: morbidity and survival in a referral cancer center
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Introduction: Pelvic exenteration (PE) is associated with a significant morbidity, and
should be indicated in selected cases. Better surgical outcomes and morbidity rates
(23% to 44%) have been observed at referral centers, with larger numbers of cases.
Objective: To evaluate the outcomes patients submitted to PE due to gynecologic
cancer, from a single referral center.
Pelvic exenteration in gynecologic cancer: morbidity and survival in a referral cancer center
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Methods: Retrospective analysis of patients with gynecologic cancer submitted to PE
between May 2008 and May 2015. Clinical, surgical and pathologic data were collected
and correlated with morbidity, recurrence and survival.
Pelvic exenteration in gynecologic cancer: morbidity and survival in a referral cancer center
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Results: 46 patients were included, with a mean age of 47.1 years-old and mean BMI of
26.9 Kg/m2. Primary tumors were located in the cervix (n=27), ovary (n=10),
endometrium (n=6), vagina (n=2) and vulva (n=1). Most tumors were stage III (n=17).
Main reason for PE was persistent (41,3%) or recurrent (30,4%) disease after primary
treatment. PE was total (n=23), anterior (n=8) or posterior (n=15). Tumor largest
diameter ranged from 1.5cm to 10cm (mean: 5.5cm). Morbidity rate was 67% (all
grades), and 14 patients (30,4%) required any kind of readmission and/or reoperation
within 30 days after surgery. Recurrence occurred in 24 patients, systemic in 62.5%
(n=15), and local in 37.5% (n=9). Mean follow-up was 16.5 months (1-67.7 months),
overall survival is 69.6%, and 17 patients are currently free of disease (37%).
Pelvic exenteration in gynecologic cancer: morbidity and survival in a referral cancer center
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Conclusion: Morbidity was significant in our series, though comparable to the
literature. Recurrence was predominantly systemic. Despite being a salvage procedure,
post-PE overall survival was acceptable in this series.
Marcus Vinicius Silva Araújo Gurgel, Antenor Duarte Vilela St, 1331, Barretos/SP – Brazil [email protected]
Audrey T Tsunoda, Antenor Duarte Vilela St, 1331, Barretos/SP – Brazil [email protected]
Gynecology Oncology Department of Barretos Cancer Hospital