Management of advanced pelvic cancer by exenteration

• Published in: European journal of surgical oncology Vol. 29; no. 9; pp. 743 - 746
• Main Authors: Kecmanovic, D.M, Pavlov, M.J, Kovacevic, P.A, Sepetkovski, A.V, Ceranic, M.S, Stamenkovic, A.B
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-11-2003; Elsevier
• Subjects: Abdomen; advanced pelvic malignancies; Biological and medical sciences; Colorectal Neoplasms - mortality; Colorectal Neoplasms - surgery; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Laparoscopy; Magnetic Resonance Imaging; Male; Medical sciences; Neoplasm Metastasis; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Outcome Assessment (Health Care); Palliative Care; Pelvic Exenteration; Pelvic Neoplasms - diagnostic imaging; Pelvic Neoplasms - mortality; Pelvic Neoplasms - pathology; Pelvic Neoplasms - surgery; Survival Analysis; Tomography, X-Ray Computed; Tumors; Ultrasonography; Yugoslavia; advanced pelvic malignancies; pelvic exenteration; Human; Focal lesion; Relapse; Rectal disease; Treatment efficiency; Stage classification; Surgical resection; Malignant tumor; Clinical management; Pelvic cavity; Abdominal disease; Cohort study; Rectum; Digestive diseases; Intestinal disease; Medical imagery; Advanced stage; Diagnosis; Laparotomy
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2003.08.008

Aim: To describe our results in managing locally advanced primary or recurrent pelvic malignancies.
Method: Investigations included: clinical, laboratory, endoscopic (rectoscopy and colonoscopy) examinations, ultrasound scan, and CT scan or MRI of the abdomen and pelvis, to determine the extent of the pelvic malignancy. A careful explorative laparatomy of abdomen and pelvis was performed, followed by anterior, posterior or total pelvic exenteration.
Results: In the period June 1995–Jan 2002, 7 anterior, 2 posterior and 51 total pelvic exenterations were performed in 60 patients, distributed as follows: 28 for rectal cancer (12 primary, 16 recurrent), 20 for cervical cancer (9 primary, 11 recurrent) and 12 for other pelvic malignancies. The median survival time and overall 5-year survival rates were as follows: primary rectal cancer—50 months and 32%; recurrent rectal cancer—31 months and 17%; primary cervical cancer—46.4 months and 41% and recurrent cervical cancer—23.4 months and 16%.
During the same period, 559 of our patients were treated for primary or recurrent rectal cancer by different types of straightforward resection.
Conclusion: Pelvic exenteration is justifiable in cases of locally advanced primary and recurrent malignancies of rectum, cervical cancer and possibly in cases of other pelvic malignancies.