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"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Jaspreet Sandhu
    138 Sandhu
  2. Richard R Barakat
    629 Barakat
  3. Patrick J Boland
    160 Boland
  4. Dennis S Chi
    707 Chi
  5. Kaled M Alektiar
    333 Alektiar
  6. Yukio Sonoda
    473 Sonoda
  7. Scott R Gerst
    48 Gerst
  8. Bernard Bochner
    468 Bochner