Skip Navigation LinksHome > January 2014 - Volume 24 - Issue 1 > Morbidity After Pelvic Exenteration for Gynecological Malign...
International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000011
Surgeons Corner

Morbidity After Pelvic Exenteration for Gynecological Malignancies: A Retrospective Multicentric Study of 230 Patients

Chiantera, Vito MD*#; Rossi, Martina MD*†; De Iaco, Pierandrea MD; Koehler, Christardt PhD*; Marnitz, Simone PhD; Fagotti, Anna MD§; Fanfani, Francesco MD§; Parazzini, Fabio MD; Schiavina, Riccardo MD; Scambia, Giovanni PhD§; Schneider, Achim PhD*; Vercellino, Giuseppe Filiberto MD*

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Objective: Our study purpose was to evaluate morbidity and postoperative mortality in patients who underwent pelvic exenteration (PE) for primary or recurrent gynecological malignancies.

Methods: We identified 230 patients who underwent PE, referred to the gynecological oncology units of 4 institutions: Charitè University in Berlin, Friedrich-Schiller University in Jena, S. Orsola-Malpighi University in Bologna, and Catholic University in Rome and in Campobasso.

Results: The median age was 55 years. The tumor site was the cervix in 177 patients, the endometrium in 28 patients, the vulva in 16 patients, and the vagina in 9 patients. Sixty-eight anterior, 31 posterior, and 131 total PEs were performed in 116 women together with hysterectomy. A total of 82.6% of the patients required blood transfusion. The mean operative time was 446 (95–970) minutes, and the median hospitalization was 24 (7–210) days. We noted a major complication rate of 21.3% (n = 49). We registered 7 perioperative deaths (3%) calculated within 30 days. The operation was performed within clear margins in 166 patients (72.2%). The overall mortality rate depending on tumor site at the end of the study was 75% for vulvar cancer, 57.6% for cervical cancer, 55.6% for vaginal cancer, and 53.6% for endometrial cancer.

Conclusions: Although an important effort for surgeons and for patients, PE remains a therapeutic option with an acceptable complication rate and postoperative mortality. A strict selection of patients is mandatory to reach adequate surgical and oncologic outcomes.

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.


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