In:
International Journal of Colorectal Disease, Springer Science and Business Media LLC, Vol. 36, No. 8 ( 2021-08), p. 1701-1710
Abstract:
Pelvic exenteration (PE) is the only option for long-term cure of advanced cancer originating from different types of tumor or recurrent disease in the lower pelvis. The aim was to show differences between colorectal and non-colorectal cancer in survival and postoperative morbidity. Methods Retrospective data of 63 patients treated with total pelvic exenteration between 2013 and 2018 are reported. Pre-, intra-, and postoperative parameters, survival data, and risk factors for complications were analyzed. Results A total of 57.2% ( n = 37) of the patients had colorectal cancer, 22.3% had gynecological malignancies (vulvar ( n = 6) or cervical ( n = 8) cancer), 11.1% ( n = 7) had anal cancer, and 9.5% had other primary tumors. A total of 30.2% ( n = 19) underwent PE for a primary tumor and 69.8% ( n = 44) for recurrent cancer. The 30-day in-hospital mortality was 0%. Neoadjuvant treatment was administered to 65.1% ( n = 41) of the patients and correlated significantly with postoperative complications (odds ratio 4.441; 95% CI: 1.375–14.342, P 〉 0.05). R0, R1, R2, and Rx resections were achieved in 65.1%, 19%, 1.6%, and 14.3% of the patients, respectively. In patients undergoing R0 resection, 2-year OS and RFS were 73.2% and 52.4%, respectively. Resection status was a significant risk factor for recurrence-free and overall survival (OS) in univariate analysis. Multivariate analysis revealed age ( P = 0.021), ASA ≥ 3 ( P = 0.005), high blood loss ( P = 0.028), low preoperative hemoglobin level ( P 〈 0.001), nodal positivity ( P 〈 0.001), and surgical complications ( P = 0.003) as independent risk factors for OS. Conclusion Pelvic exenteration is a procedure with high morbidity rates but remains the only curative option for advanced or recurrent colorectal and non-colorectal cancer in the pelvis.
Type of Medium:
Online Resource
ISSN:
0179-1958
,
1432-1262
DOI:
10.1007/s00384-021-03893-y
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2021
detail.hit.zdb_id:
1459217-4
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