Pelvic exenteration in the elderly patient

Matthews, Catherine A.; Morris, Mitchell; Burke, Tom; Gershenson, D. M.; Jt, Wharton; Rutledge, Felix N.

doi:10.1016/0090-8258(92)90528-q

Cited by 28 publications

(46 citation statements)

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“…With respect to surgical treatment for residual disease after radiation therapy, the most effective method is probably pelvic exenteration (Stanhope et al, 1990). Total pelvic exenteration offers a 5-year survival rate of 23 -50%, but it requires alterations of both the urinary and lower gastrointestinal tracts, and a high rate of Hysterectomy for residual disease in cervical cancer T Ota et al severe postoperative complications, such as infection, injury of the urinary and lower gastrointestinal tracts, and small-bowel obstruction, occur, in addition to a 4 -14% surgery-related mortality rate (Rutledge et al, 1977;Morley et al, 1989;Shingleton et al, 1989;Matthews et al, 1992;Moutardier et al, 2004). The utility of radical hysterectomy, a more conservative procedure, has been reported, but it also has a high rate of complications.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant hysterectomy for treatment of residual disease in patients with cervical cancer treated with radiation therapy

et al. 2008

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The objective of this retrospective study was to determine the efficacy of adjuvant hysterectomy for treatment of residual disease in cervical carcinoma treated with radiation therapy. Between 1971 and 1996, 1590 patients with carcinoma of the uterine cervix (stages I -IIIb) were treated with radiation therapy. Three months after completion of radiation therapy, the status of local control was investigated, and total abdominal hysterectomy was performed in cases in which central residual disease existed in the cervix. Of the 1590 patients, residual disease was identified in 162 patients. Among these patients, 35 showed an absence of distant metastasis or lateral parametrial invasion and underwent hysterectomy. The overall 5-and 10-year survival rates for these patients were 68.6 and 65.7%, respectively. There was no significant difference in survival between patients with squamous cell carcinoma and those with non-squamous cell carcinoma or between patients with stage I/II carcinoma and those with stage III carcinoma. With respect to treatment-related morbidity, five (14.3%) patients suffered grade III or IV complications after hysterectomy. Adjuvant hysterectomy is an effective addition to radiation therapy in the treatment of cervical cancer, even in patients with stage III disease and in those with non-squamous cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Adjuvant hysterectomy for treatment of residual disease in patients with cervical cancer treated with radiation therapy

et al. 2008

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“…Chronological age is not an absolute contra-indication for the procedure. Well selected elderly patients may have the same outcome as younger patients (Lichtinger et al, 1986;Matthews et al, 1992). In our series, median age of the patients is 50 years and the oldest patient was 60 years old.…”

Section: Discussionmentioning

confidence: 87%

Characteristics of Gynecologic Oncology Patients in King Chulalongkorn Memorial Hospital - Complications and Outcome of Pelvic Exenteration

Oranratanaphan

Termrungruanglert²,

Sirisabya³

2013

Asian Pacific Journal of Cancer Prevention

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“…4,15 As such, we also evaluated the factors that would suggest a poorer candidate for these extensive pelvic surgeries. Patient demographics (age, gender, and comorbidity index) and nature of tumor (primary or recurrent) did not prognosticate subsequent disease recurrence or overall survival.…”

Section: Discussionmentioning

confidence: 99%

Urological reconstruction after pelvic oncological surgery: A single institution experience

Tan

et al. 2017

Asian Journal of Surgery

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Summary Background: In locally advanced pelvic malignancies, there is often involvement of urological organs, necessitating resection and reconstruction, which can be associated with significant complications. Methods: We retrospectively reviewed 20 patients undergoing urological reconstructions during pelvic oncological surgeries from January 2004 to December 2013. All patients had imagingproven involvement of at least one urological organ preoperatively. Primary outcome was urological complication rate. Secondary outcomes were nonurological complication, recurrence rate, and overall survival. Results: Median age of presentation was 51 years. Six and 14 patients underwent resections for primary and secondary tumors, respectively. Colorectal tumors were the most common, followed by gynecological cancers. The ureter was the most common urological organ involved, followed by the bladder, prostate, and seminal vesicles. Reconstructive procedures included ileal and sigmoid conduits, ureteroneocystostomies, Boari flap, transureteroureterostomies (TUUs) and direct ureteroureterostomies. Six patients developed major urological complications, requiring endoscopic and surgical reinterventions. The follow-up time was 34 months. Thirteen patients developed recurrence, associated with higher tumor grade and lymphovascular invasion, and occurred at a median time of 10 months. These patients had an overall survival of 20 months, compared to 45 months in patients without recurrence. Conclusion: Careful patient selection in pelvic oncological surgeries can significantly prolong survival. Recurrent tumors and greater intraoperative blood loss are associated with higher urological complications. A limited pelvic exenteration and lower radiation doses can reduce

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Pelvic exenteration in the elderly patient

Cited by 28 publications

References 0 publications

Adjuvant hysterectomy for treatment of residual disease in patients with cervical cancer treated with radiation therapy

Adjuvant hysterectomy for treatment of residual disease in patients with cervical cancer treated with radiation therapy

Characteristics of Gynecologic Oncology Patients in King Chulalongkorn Memorial Hospital - Complications and Outcome of Pelvic Exenteration

Urological reconstruction after pelvic oncological surgery: A single institution experience

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