Survival After Pelvic Exenteration for Cervical Cancer

Bouraoui, I; Bouaziz, Hanen; Tounsi, Noureddine; Romdhane, R Ben; Hechiche, M; Slimane, Maher; Rahal, Khaled

doi:10.1007/s13224-021-01502-0

Cited by 10 publications

(8 citation statements)

References 14 publications

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“…Our findings suggest that smaller volume hospitals can perform PE procedures with a low complication and reoperation rate. In our cohort, the postoperative mortality rate was 0%, which is consistent with data reported by other groups (0-5%) [24,26]. The 5-year survival analysis showed much better outcomes for patients younger than 50 years and older than 70 years; those aged 50-70 years experienced worse outcomes but this disparity may be due to small cell frequency.…”

Section: F I G U R E 3 Survival Prognosis By Patient Characteristicssupporting

confidence: 91%

“…experienced a urinary tract infection and 12% had a wound infection, rates which are comparable to the literature [13,24,26]. Follow-up studies found that mild renal failure was present in most patients in the incontinent urinary diversion group and infection was predominant in the continent diversion group.…”

Section: F I G U R E 3 Survival Prognosis By Patient Characteristicssupporting

confidence: 81%

“…The PE complication rate described in the literature varies greatly. Some authors report complication rates of 78-81% [13,24,25] whereas others report that up to 62% of the cohort were free of complications [26]. Most authors agree that the more common postoperative complications are urinary tract and wound infections [14,26].…”

Section: Discussionmentioning

confidence: 99%

“…While palliative chemotherapy can provide a median overall survival (OS) of up to 10 months on average [31], PE can provide three times longer median OS for selected patients. Surgery is the only method of treatment that achieves as high as a 40% 5-year survival for these patients [24,28,32] whose treatment options have been exhausted.…”

Section: F I G U R E 3 Survival Prognosis By Patient Characteristicsmentioning

confidence: 99%

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Is long-term survival possible when conventional cervical cancer treatment options are exhausted?

2024

EJGO

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When local recurrence happens, treatment options are limited due to the frequent use of pelvic irradiation for primary cervical cancer. Reirradiation is usually contraindicated and chemotherapy is ineffective at controlling tumors located within the previously irradiated tissue, in the case of persistent or recurrent cervical cancer, pelvic exenteration (PE) is on of the few options to offer patients a radical treatment. This is the first analysis from Estonia evaluating prognostic factors associated with locally advanced cervical cancer and the potential for long-term survival with pelvic exenteration. Between 2001 and 2021, PE was performed in 25 patients with recurrent or persistent pelvic cancer after radical radiochemotherapy. Included were 22 cervical cancer and 3 vaginal cancer cases who were followed until 01 June 2022. Clinicopathological characteristics of patients were described in univariate analysis and prognostic factors were estimated with Cox proportional hazard analysis. The median age was 58 years (range 34-80). Median tumor diameter was 6 cm (range 2-14 cm). Total PE, anterior PE and PE with rectal anastomosis consisted of 44%, 36% and 20% of cases respectively. Additional vulvectomy was performed 28% of patients. The median follow-up was 92 months. The overall postoperative complication rate was 32%; the postoperative mortality rate was 0%. Median hospitalization was 16 days (range 9-34). Overall survival was as follows: 1 year 64%, 3 year 40%, 5 year 32% and 15 year 24%. In this case series, we find that even in patients with recurrent or persistent locally advanced cervical cancer, at least a quarter of patients treated with pelvic exenteration can achieve a survival of more than 15 years. PE can be performed with a low postoperative complication rate and zero mortality. PE allows significantly longer survival for patients who have exhausted other treatment modalities.

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Section: F I G U R E 3 Survival Prognosis By Patient Characteristicssupporting

confidence: 91%

Section: F I G U R E 3 Survival Prognosis By Patient Characteristicssupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: F I G U R E 3 Survival Prognosis By Patient Characteristicsmentioning

confidence: 99%

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Is long-term survival possible when conventional cervical cancer treatment options are exhausted?

2024

EJGO

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“…In some cases, neoadjuvant chemotherapy (NAC) can also be employed to reduce tumor mass before surgical approaches ( 7 ). However, when cancer does not respond to concomitant therapies, salvage surgery is carried out with demolition procedures that in most cases require emptying the pelvis and definitive urostomies and colostomies ( 8 , 9 ). Predicting the degree of cancer response to chemotherapy/radiation therapy from the diagnosis to personalize the clinical approach represents the biggest challenge in locally advanced cancers.…”

Section: Introductionmentioning

confidence: 99%

Emerging Role of MicroRNAs in the Therapeutic Response in Cervical Cancer: A Systematic Review

et al. 2022

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Cervical cancer is a common female cancer, with nearly 600,000 cases and more than 300,000 deaths worldwide every year. From a clinical point of view, surgery plays a key role in early cancer management, whereas advanced stages are treated with chemotherapy and/or radiation as adjuvant therapies. Nevertheless, predicting the degree of cancer response to chemotherapy or radiation therapy at diagnosis in order to personalize the clinical approach represents the biggest challenge in locally advanced cancers. The feasibility of such predictive models has been repeatedly assessed using histopathological factors, imaging and nuclear methods, tissue and fluid scans, however with poor results. In this context, the identification of novel potential biomarkers remains an unmet clinical need, and microRNAs (miRNAs) represent an interesting opportunity. With this in mind, the aim of this systematic review was to map the current literature on tumor and circulating miRNAs identified as significantly associated with the therapeutic response in cervical cancer; finally, a perspective point of view sheds light on the challenges ahead in this tumor.Systematic Review RegistrationPROSPERO (CRD42021277980).

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Post-traumatic reactions and quality of life after pelvic exenteration for gynecologic cancer: a retrospective cohort study

Thompson,

Loecher,

Albizu-Jacob

et al. 2024

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Survival After Pelvic Exenteration for Cervical Cancer

Cited by 10 publications

References 14 publications

Is long-term survival possible when conventional cervical cancer treatment options are exhausted?

Is long-term survival possible when conventional cervical cancer treatment options are exhausted?

Emerging Role of MicroRNAs in the Therapeutic Response in Cervical Cancer: A Systematic Review

Post-traumatic reactions and quality of life after pelvic exenteration for gynecologic cancer: a retrospective cohort study

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