Survival After Curative Pelvic Exenteration for Primary or Recurrent Cervical Cancer: A Retrospective Multicentric Study of 167 Patients

Abstract

Pelvic exenteration is a valid therapeutic option for patients with locally advanced primary persistent or recurrent cervical cancer, with a long-term survival in 40% of the patients.

Clinical outcome of recurrent locally advanced cervical cancer (LACC) submitted to primary multimodality therapies

“…Pelvic exenteration indeed, represents a valid therapeutic option for patients with previously irradiated central pelvic recurrence, with 5-years survival rates reported between 30% and 40% [26,27]. In addition, possible indications for pelvic exenteration have widened over the years, by including in the last decade, patients with specific features (e.g.…”

“…no tumor infiltration at the site of the sciatic foramen, no leg oedema) of lateral pelvic recurrences, who can equally benefit from pelvic exenteration with laterally extended endopelvic resection (LEER) with curative intent [27][28][29]. On the contrary exclusion criteria for secondary pelvic exenteration still vary considerably: whereas the majority of surgeons consider intraperitoneal tumor spread and multiple distant metastases as absolute contraindications to pelvic exenteration, lymph node involvement, large tumor size, or disease free survival b6 months, despite having both a negative impact on survival, are not unanimously regarded as absolute exclusion criteria for this ultraradical procedure [26,27]. In this context, we confirmed, as discussed above, the detrimental role of peritoneal recurrence as carcinosis, whereas tumor size of the recurrence and the interval time from the completion of primary treatment (i.e.…”

Prognostic Factors for Curative Pelvic Exenterations in Patients With Recurrent Uterine Cervical or Vaginal Cancer

“…Since the Shingleton et al 12 study in 1989, it has been assumed that the main prognostic factor for DFS and OS is the 13,14 Other known prognostic factors include a recurrence time of less than 18 months or 2 years, 9,15 lymph node involvement at the time of initial treatment, 16 and perinervous invasion. 7 We also determined that 2 previously known factors are prognostic indicators, namely, tumor recurrence size greater than 5 cm 11 and mesorectal lymph node involvement.…”

Quality of Life in Women After Pelvic Exenteration for Gynecological Malignancies

“…9Y11 The therapeutic role of PE is supported by encouraging survival data from large retrospective series, which demonstrated a 5-year overall survival after PE ranging from 25% to 50%. 9,10,12,13 In this context, it is well known that besides the impact of cancer diagnosis by itself, the surgical removal of organs accomplishing reproductive functions significantly affects QoL in women with gynecological cancer. 5 Therefore, it is conceivable to hypothesize that the impairment of bowel, urinary, and sexual functions related to mutilating surgical approach, such as PE, may have profound psychological implications on women's self-identity and QoL.…”