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Pelvic Exenteration for Recurrent Endometrial Adenocarcinoma: A Retrospective Multi-institutional Study About 21 Patients

Chiantera, Vito MD; Rossi, Martina MD*†; De Iaco, Pierandrea MD; Koehler, Christardt PhD*; Marnitz, Simone PhD; Gallotta, Valerio MD§; Margariti, Alessandro Pasquale MD§; Parazzini, Fabio MD; Scambia, Giovanni PhD§; Schneider, Achim PhD*; Vercellino, Giuseppe Filiberto MD*

International Journal of Gynecological Cancer: June 2014 - Volume 24 - Issue 5 - p 880–884
doi: 10.1097/IGC.0000000000000002
Uterine Cancer

Objective: The aim of our study was to evaluate morbidity, mortality, and long-term survival of patients who underwent pelvic exenteration (PE) with curative intent for recurrence of endometrial adenocarcinoma during a single decade.

Methods: We defined a cohort of 21 patients who met our inclusion criteria, referred to 4 cooperating gynecologic oncology settings in Germany and Italy between 2000 and 2011. Data regarding surgery, histology, and oncologic outcomes were collected and statistically evaluated. Survival was determined from the day of exenteration until the last follow-up or death.

Results: The median age was 66 years. A total of 42.9% of the patients had major complications, and a complete resection was achieved in 85.7% of the patients. A total of 71.4% of the patients had negative nodes. No patient died intraoperatively. The perioperative mortality, calculated within 30 days from PE, was 4.8%. The overall 5-year survival rate, evaluated using the Kaplan-Meier method, was 40%. For the subgroup with complete resection and negative lymph nodes, overall survival reached 60%.

Conclusions: Despite a high complication rate, PE for solitary pelvic recurrence of endometrial cancer yields a high rate of long-term survival.

*Department of Gynecology and Gynecological Oncology, Campus Mitte (CCM) and Campus Benjamin Franklin (CBF), Charitè University, Berlin, Germany; †Gynecologic Oncology Unit, S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy; ‡Department of Radiooncology, Campus Mitte (CCM) and Campus Virchow (CVK), Charitè University, Berlin, Germany; §Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy; ∥Università di Milano, Fondazione Policlinico, Milan, Italy; and ¶Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Campobasso, Italy.

Address correspondence and reprint requests to Vito Chiantera, MD, Department of Gynecology and Gynecological Oncology, Charitè University, Hindenburgdamm 30, 12203 Berlin, Germany. E-mail: vito.chiantera@charite.de.

The authors declare no conflicts of interest.

Received June 7, 2013

Accepted August 18, 2013

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