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BMC Cancer
Published in: BMC Cancer 1/2024

Open Access 01-12-2024 | Cervical Cancer | Research

Long-term outcomes of pelvic exenterations for gynecological malignancies: a single-center retrospective cohort study

Authors: Jie-Hai Yu, Chong-Jie Tong, Qi-Dan Huang, Yun-Lin Ye, Gong Chen, Hao Li, Yong-Shan Wen, Fan Yang, Nan-Bin Luo, Guang-Yu Xu, Ying Xiong

Published in: BMC Cancer | Issue 1/2024

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Abstract

Background

Recently, with the advancement of medical technology, the postoperative morbidity of pelvic exenteration (PE) has gradually decreased, and it has become a curative treatment option for some patients with recurrent gynecological malignancies. However, more evidence is still needed to support its efficacy. This study aimed to explore the safety and long-term survival outcome of PE and the feasibility of umbilical single-port laparoscopic PE for gynecologic malignancies in a single medical center in China.

Patients and methods

PE for gynecological cancers except for ovarian cancer conducted by a single surgical team in Sun Yat-sen University Cancer Center between July 2014 and December 2019 were included and the data were retrospectively analyzed.

Results

Forty-one cases were included and median age at diagnosis was 53 years. Cervical cancer accounted for 87.8% of all cases, and most of them received prior treatment (95.1%). Sixteen procedures were performed in 2016 and before, and 25 after 2016. Three anterior PE were performed by umbilical single-site laparoscopy. The median operation time was 460 min, and the median estimated blood loss was 600 ml. There was no perioperative death. The years of the operations was significantly associated with the length of the operation time (P = 0.0018). The overall morbidity was 52.4%, while the severe complications rate was 19.0%. The most common complication was pelvic and abdominal infection. The years of surgery was also significantly associated with the occurrence of severe complication (P = 0.040). The median follow-up time was 55.8 months. The median disease-free survival (DFS) was 17.9 months, and the median overall survival (OS) was 25.3 months. The 5-year DFS was 28.5%, and the 5-year OS was 30.8%.

Conclusion

PE is safe for patient who is selected by a multi-disciplinary treatment, and can be a curative treatment for some patients. PE demands a high level of experience from the surgical team. Umbilical single-port laparoscopy was a technically feasible approach for APE, meriting further investigation.
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Metadata
Title
Long-term outcomes of pelvic exenterations for gynecological malignancies: a single-center retrospective cohort study
Authors
Jie-Hai Yu
Chong-Jie Tong
Qi-Dan Huang
Yun-Lin Ye
Gong Chen
Hao Li
Yong-Shan Wen
Fan Yang
Nan-Bin Luo
Guang-Yu Xu
Ying Xiong
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-024-11836-3

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