Pelvic exenteration for recurrent or persistent gynecologic malignancies: Clinical and histopathologic factors predicting recurrence and survival in a modern cohort Journal Article


Authors: Straubhar, A. M.; Chi, A. J.; Zhou, Q. C.; Iasonos, A.; Filippova, O. T.; Leitao, M. M. Jr; Awowole, I. O.; Abu-Rustum, N. R.; Broach, V. A.; Jewell, E. L.; Sandhu, J. S.; Sonoda, Y.
Article Title: Pelvic exenteration for recurrent or persistent gynecologic malignancies: Clinical and histopathologic factors predicting recurrence and survival in a modern cohort
Abstract: Objectives. To explore pre-operative factors and their impact on overall survival (OS) in a modern cohort of patients who underwent pelvic exenteration (PE) for gynecologic malignancies. Methods. A retrospective review was performed for all patients who underwent a PE from 1/1/2010 through 12/31/2018 at our institution. Inclusion criteria were exenteration due to recurrent or progressive carcinoma of the uterus, cervix, vagina or vulva, with histologically confirmed complete surgical resection of the malignancy. Exclusion criteria included PE for palliation of symptoms without recurrence, and for ovarian or rare histologic malignancies. Univariable and multivariable analysis were performed to identify factors predicting prolonged survival. Results. Overall, 71 patients met the inclusion criteria. Median age at time of exenteration was 62 years (range, 28-86 years). Vulvar cancer was the most common primary diagnosis (32%); 30% had cervical cancer; 23%, uterine cancer; 15%, vaginal cancer. Median OS was 55.1 months (95% confidence interval (CI): 36-not estimable) with a median follow-up time of 40.8 months (95% CI: 1-116.1). On univariable analysis, age > 62 years (hazard ratio (HR) 2.71, 95% CI 1.27-5.79), American Society of Anesthesia (ASA) 3-4 (HR: 3.41 (95% CI 1.03-11.29), and vulvar cancer (HR 4.19 (95% CI 1.17-14.96) predicted worse OS. Tumor size and prior progression-free interval (PFI) did not meet statistical significance in OS analyses. On multivariable analysis, there were no significant factors associated with worse OS. Conclusions. PE performed with curative intent may be considered a treatment option in well-counseled, carefully selected patients, irrespective of tumor size and PFI before exenteration. (c) 2021 Elsevier Inc. All rights reserved.
Keywords: experience; recurrent disease; pet/ct; gynecologic malignancy; pelvic exenteration; cancer
Journal Title: Gynecologic Oncology
Volume: 163
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2021-11-01
Start Page: 294
End Page: 298
Language: English
ACCESSION: WOS:000714728500012
DOI: 10.1016/j.ygyno.2021.08.033
PROVIDER: wos
PMCID: PMC8585715
PUBMED: 34518053
Notes: Article -- Source: Wos
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Jaspreet Sandhu
    138 Sandhu
  2. Elizabeth Jewell
    131 Jewell
  3. Yukio Sonoda
    473 Sonoda
  4. Mario Leitao
    576 Leitao
  5. Qin Zhou
    255 Zhou
  6. Alexia Elia Iasonos
    364 Iasonos
  7. Vance Andrew Broach
    116 Broach
  8. Andrew Chi
    10 Chi