A modern-day experience with Brunschwig's operation: Outcomes associated with pelvic exenteration

Autor: Eric, Rios-Doria, Olga T, Filippova, Alli M, Straubhar, Andrew, Chi, Ibraheem, Awowole, Jaspreet, Sandhu, Vance, Broach, Jennifer J, Mueller, Ginger J, Gardner, Elizabeth L, Jewell, Oliver, Zivanovic, Mario M, Leitao, Kara, Long Roche, Nadeem R, Abu-Rustum, Yukio, Sonoda
Rok vydání: 2022
Předmět:
Zdroj: Gynecologic Oncology. 167:277-282
ISSN: 0090-8258
DOI: 10.1016/j.ygyno.2022.08.017
Popis: To evaluate postoperative and oncologic outcomes associated with pelvic exenteration for non-ovarian gynecologic malignancies.This was a retrospective review of patients who underwent pelvic exenteration for non-ovarian gynecologic malignancies at our institution from 1/1/2010-12/31/2019. Palliative exenteration cases were excluded from survival analysis. Postoperative complications were early (≤30 days) or late (31-180 days). Complications were graded using a validated institutional scale. Major complications were considered grade ≥ 3. Categorical variables were compared using the chi-square test, and the Kaplan-Meier method was used for survival analysis.Of 100 patients identified, 89 underwent pelvic exenteration for recurrent disease, 5 for palliation, 5 for primary disease, and 1 for persistent disease. Thirty percent had cervical, 27% vulvar, 24% uterine, and 19% vaginal cancer. Sixty-two percent underwent total, 30% anterior, and 8% posterior exenteration. No deaths occurred intraoperatively or within 30 days of surgery. Six patients died after 30 days. Ninety-seven experienced a perioperative complication-49 early, 1 late, and 47 both. Fifty experienced a major complication-22 (44%) early, 19 (38%) late, and 9 (18%) both. No variables were statistically associated with complication development. The 3-year progression-free survival rate was 61.0%; the 3-year overall survival rate was 61.6%. Of 58 surviving patients, 16 (28%) and 4 (7%) were alive after 5 and 10 years, respectively.The overall complication rate for pelvic exenteration remains high. No variables demonstrated association with complication development as the rate was nearly 100%. The low rate of perioperative mortality is likely due to improved perioperative care.
Databáze: OpenAIRE
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