Extended pelvic resections for recurrent or persistent uterine and cervical malignancies: An update on out of the box surgery Journal Article
| Authors: | Andikyan, V.; Khoury-Collado, F.; Sonoda, Y.; Gerst, S. R.; Alektiar, K. M.; Sandhu, J. S.; Bochner, B. H.; Barakat, R. R.; Boland, P. J.; Chi, D. S. |
| Article Title: | Extended pelvic resections for recurrent or persistent uterine and cervical malignancies: An update on out of the box surgery |
| Abstract: | Objective: To update our report on the outcome of patients who underwent extended pelvic resection (EPR) for recurrent or persistent uterine and cervical malignancies. Methods: We reviewed the records of all patients who underwent EPR between 6/2000 and 07/2011. EPR was defined as an en-bloc resection of a pelvic tumor with sidewall muscle, bone, major nerve, and/or major vascular structure. Complications up to 180 days post surgery were analyzed. Survivals were estimated using the Kaplan-Meier method. Results: We identified 22 patients. Median age at the time of EPR was 58 years (range, 36-74). Median tumor diameter was 5.4 cm (range, 1.5-11.2). Primary tumor sites included: uterus, 13; cervix, 7; synchronous uterus/cervix, 1; and synchronous uterus/ovary, 1. The EPR structures were: muscle, 13; nerve, 10; bone, 8; vessel, 5. Complete gross resection with microscopically negative margins (R0 resection) was achieved in 17 patients (77%). There were no perioperative mortalities. Major postoperative complications occurred in 14 patients (64%). The two most common morbidities were pelvic abscesses and peripheral neuropathies. Median follow-up time was 28 months (range, 6-99). The 5-year overall survival (OS) for the entire cohort was 34% (95% CI, 13-57). For the 17 patients who had an R0 resection, the 5-year OS was 48% (95% CI, 19-73). In patients with positive pathologic margins (n = 5), the 5-year OS was 0%. Conclusion: EPR was associated with prolonged survival when an R0 resection was achieved. The high rate of postoperative complications remains a hallmark of these procedures and properly selected patients should be extensively counseled preoperatively. © 2012 Elsevier Inc. All rights reserved. |
| Keywords: | recurrence; outcome; complication; extended pelvic resection; exenteration |
| Journal Title: | Gynecologic Oncology |
| Volume: | 125 |
| Issue: | 2 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2012-05-01 |
| Start Page: | 404 |
| End Page: | 408 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2012.01.031 |
| PROVIDER: | scopus |
| PUBMED: | 22285844 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 May 2012" - "CODEN: GYNOA" - "Source: Scopus" |
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