Pelvic exenteration with curative intent for recurrent uterine malignancies Journal Article

Authors: Khoury-Collado, F.; Einstein, M. H.; Bochner, B. H.; Alektiar, K. M.; Sonoda, Y.; Abu-Rustum, N. R.; Brown, C. L.; Gardner, G. J.; Barakat, R. R.; Chi, D. S.
Article Title: Pelvic exenteration with curative intent for recurrent uterine malignancies
Abstract: Objective: To evaluate the outcomes observed with pelvic exenteration with curative intent for recurrent uterine malignancies in the modern era. Methods: We reviewed the records of all patients who underwent this procedure at our institution between 1/1997 and 03/2011. Postoperative complications up to 90 days after surgery were analyzed and graded as per our institution grading system. Survivals were estimated using the Kaplan-Meier method. Results: During the study period, 21 patients were identified. Median age at the time of exenteration was 57 years (range, 36-75). Median tumor size was 6 cm (range, microscopic - 14.5). Tumor histology was: endometrioid, 10 cases; mixed, serous, and carcinosarcoma, 7 cases; and sarcomas, 4 cases. The type of exenteration was: total, 14 cases; anterior, 6 cases and posterior, 1 case. There were no intra- or postoperative mortalities. Seven patients (33%) developed at least one grade 2 complication, and 10 patients (48%) developed at least one grade 3 complication. Five (24%) patients had to be re-operated on in the first 90 days post surgery. The median follow up time after exenteration was 39 months (range, 5-112). The 5-year survival of the entire cohort was 40% (95% CI: 18-63). An improved survival was observed in patients with endometrioid tumors and sarcomas (5-year survival rates of 50% and 66%, respectively). The presence of pelvic sidewall involvement and/or hydronephrosis did not negatively affect survival. Conclusion: Pelvic exenteration for recurrent uterine malignancies can be associated with long-term survival in properly selected patients. A high rate of postoperative complications remains a hallmark of this procedure and should be discussed carefully with patients facing this decision. © 2011 Elsevier Inc. All rights reserved.
Keywords: adult; cancer survival; clinical article; aged; survival rate; cancer recurrence; outcome assessment; follow up; endometrioid carcinoma; tumor volume; incidence; medical record review; histology; postoperative complication; survival time; thromboembolism; pelvis exenteration; reoperation; urinary tract infection; postoperative infection; hospital readmission; uterus cancer; uterus sarcoma; uterine cancer; carcinosarcoma; peroperative complication; pelvic exenteration; digestive system fistula; recurrent uterine malignancies
Journal Title: Gynecologic Oncology
Volume: 124
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2012-01-01
Start Page: 42
End Page: 47
Language: English
DOI: 10.1016/j.ygyno.2011.09.031
PROVIDER: scopus
PUBMED: 22014627
Notes: --- - "Export Date: 3 January 2012" - "CODEN: GYNOA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Ginger J Gardner
    211 Gardner
  2. Richard R Barakat
    629 Barakat
  3. Carol Brown
    151 Brown
  4. Dennis S Chi
    600 Chi
  5. Kaled M Alektiar
    290 Alektiar
  6. Yukio Sonoda
    374 Sonoda
  7. Bernard Bochner
    406 Bochner