Anterior pelvic exenteration with total vaginectomy for recurrent or persistent genitourinary malignancies: Review of surgical technique, complications, and outcome Journal Article

  

Authors:	Andikyan, V.; Khoury-Collado, F.; Gerst, S. R.; Talukdar, S.; Bochner, B. H.; Sandhu, J. S.; Abu Rustum, N.; Sonoda, Y.; Barakat, R. R.; Chi, D. S.
Article Title:	Anterior pelvic exenteration with total vaginectomy for recurrent or persistent genitourinary malignancies: Review of surgical technique, complications, and outcome
Abstract:	Objective: To describe the surgical technique, complications, and outcomes after anterior pelvic exenteration with total vaginectomy (AETV) for recurrent or persistent genitourinary malignancies. Methods: We reviewed the medical records of all patients who underwent AETV between 12/2002 and 07/2011. Relevant demographic, clinical, and pathological information was collected. Postoperative complications and rates of readmission and reoperation (up to 180 days after surgery) were examined, and preliminary survival data were obtained. Results: We identified 11 patients who underwent AETV. The median age at the time of the surgery was 55 years (range, 36-71). The median tumor size was 0.9 cm (range, microscopic - 4). Primary tumor sites included: cervix, 6; uterus, 3; vagina, 1; and urethra, 1. Complete surgical resection with negative pathologic margins was achieved in all 11 patients. Major postoperative complications occurred in 4 patients (36%). Six patients (55%) required readmission to the hospital. No operative mortalities were observed, and none of the patients required a re-operation. With a median follow-up after the procedure of 25 months (range, 6-95), none of the patients developed a pelvic recurrence. Ten patients (91%) were alive without evidence of disease and one patient (9%) developed a pancreatic recurrence. Conclusion: AETV sparing the rectosigmoid and anus is feasible in highly selected patients with central pelvic recurrences. Compared to previously reported studies on total pelvic exenteration, data from this case series suggest that AETV may be associated with a lower rate of complications without compromising the oncologic outcome, while also preserving rectal function. © 2012 Elsevier Inc. All rights reserved.
Keywords:	adult; cancer survival; clinical article; treatment outcome; aged; middle aged; surgical technique; retrospective studies; cancer recurrence; carcinoma, squamous cell; pancreas cancer; chemotherapy, adjuvant; radiotherapy, adjuvant; follow up; adenocarcinoma; neoplasm recurrence, local; tumor volume; vagina; medical record review; urogenital tract cancer; time factors; postoperative complication; urogenital neoplasms; uterine cervix cancer; urologic surgery; reoperation; blood transfusion; outcome; hospital readmission; uterus cancer; blood loss, surgical; complication; pelvic exenteration; vagina cancer; feasibility; anterior pelvic exenteration; total vaginectomy; anterior pelvic exenteration with total vaginectomy; urethra cancer; patient readmission
Journal Title:	Gynecologic Oncology
Volume:	126
Issue:	3
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2012-09-01
Start Page:	346
End Page:	350
Language:	English
DOI:	10.1016/j.ygyno.2012.04.034
PROVIDER:	scopus
PUBMED:	22555107
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84864399216&partnerID=40&md5=434c8c33f782dac525e220cf86899664
Notes:	--- - "Export Date: 4 September 2012" - "CODEN: GYNOA" - "Source: Scopus"