Dirk Michael Forner1, Bjoern Lampe. 1. Department of Obstetrics and Gynecology, Florence Nightingale Hospital, Kaiserwerther Diakonie, Dusseldorf, Germany. dr.forner@gmx.de
Abstract
OBJECTIVE: Whereas pelvic exenteration is an established therapy for the treatment of recurrent cervical carcinoma, it is not often performed for primary locally advanced cervical cancer (LACC). STUDY DESIGN: This retrospective study analyzed survival data and prognostic factors of 35 patients with LACC who were treated by pelvic exenteration. RESULTS: After surgery, 33 patients (97%) were macroscopically free of tumor. In 20 patients, pelvic lymph nodes (LN) were involved, and in 6 of these, metastatic tissue had reached the paraaortal nodes. Overall, the patients' mean 5 year survival was 43%, and the median survival time was 30 months; these values ranged from 15% to 70% and from 15 to 44 months, respectively, depending on LN involvement (P=.006). Pelvic LN involvement was the only significant factor for overall survival found in the multivariate analysis (P=.02). CONCLUSION: In LACC with free LNs and no distant metastases, pelvic exenteration has good long-term results.
OBJECTIVE: Whereas pelvic exenteration is an established therapy for the treatment of recurrent cervical carcinoma, it is not often performed for primary locally advanced cervical cancer (LACC). STUDY DESIGN: This retrospective study analyzed survival data and prognostic factors of 35 patients with LACC who were treated by pelvic exenteration. RESULTS: After surgery, 33 patients (97%) were macroscopically free of tumor. In 20 patients, pelvic lymph nodes (LN) were involved, and in 6 of these, metastatic tissue had reached the paraaortal nodes. Overall, the patients' mean 5 year survival was 43%, and the median survival time was 30 months; these values ranged from 15% to 70% and from 15 to 44 months, respectively, depending on LN involvement (P=.006). Pelvic LN involvement was the only significant factor for overall survival found in the multivariate analysis (P=.02). CONCLUSION: In LACC with free LNs and no distant metastases, pelvic exenteration has good long-term results.