Morbidity after pelvic exenteration for gynecological malignancies: A retrospective multicentric study of 230 patients

Vito Chiantera, Martina Rossi, Pierandrea De Iaco, Christardt Koehler, Simone Marnitz, Anna Fagotti, Francesco Fanfani, Fabio Parazzini, Riccardo Schiavina, Giovanni Scambia, Achim Schneider, Giuseppe Filiberto Vercellino

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Abstract

Objective: Our study purposewas to evaluatemorbidity and postoperative mortality in patients who underwent pelvic exenteration (PE) for primary or recurrent gynecological malignancies. Methods: We identified 230 patients who underwent PE, referred to the gynecological oncology units of 4 institutions: Charitè University in Berlin, Friedrich-Schiller University in Jena, S. Orsola-Malpighi University in Bologna, and Catholic University in Rome and in Campobasso. Results: The median age was 55 years. The tumor site was the cervix in 177 patients, the endometrium in 28 patients, the vulva in 16 patients, and the vagina in 9 patients. Sixty-eight anterior, 31 posterior, and 131 total PEs were performed in 116 women together with hysterectomy. A total of 82.6% of the patients required blood transfusion. The mean operative time was 446 (95-970) minutes, and the median hospitalization was 24 (7-210) days. We noted a major complication rate of 21.3% (n = 49). We registered 7 erioperative deaths (3%) calculated within 30 days. The operation was performed within clear margins in 166 patients (72.2%). The overall mortality rate depending on tumor site at the end of the study was 75%for vulvar cancer, 57.6%for cervical cancer, 55.6%for vaginal cancer, and 53.6% for endometrial cancer. Conclusions: Although an important effort for surgeons and for patients, PE remains a therapeutic option with an acceptable complication rate and postoperative mortality. A strict selection of patients is mandatory to reach adequate surgical and oncologic outcomes.

Original languageEnglish
Pages (from-to)156-164
Number of pages9
JournalInternational Journal of Gynecological Cancer
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 2014

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Keywords

  • Gynecological malignancies
  • Morbidity
  • Mortality
  • Pelvic exenteration

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Chiantera, V., Rossi, M., De Iaco, P., Koehler, C., Marnitz, S., Fagotti, A., Fanfani, F., Parazzini, F., Schiavina, R., Scambia, G., Schneider, A., & Vercellino, G. F. (2014). Morbidity after pelvic exenteration for gynecological malignancies: A retrospective multicentric study of 230 patients. International Journal of Gynecological Cancer, 24(1), 156-164. https://doi.org/10.1097/IGC.0000000000000011